Homepathic or not? Guess the abstract game

Re: Homepathic or not? Guess the abstract game

Francisco Gomez — Fri, 09 Aug 2013 22:53:58 GMT

You pissed me off this time. :-) I wanted to play the game. You gave answer the game too soon! I've been doing 10hours/day last five days away from home and I just got back! :-/

Re: Homepathic or not? Guess the abstract game

John Flynn — Fri, 09 Aug 2013 19:13:24 GMT

Ahh... you're all too good.

Paper1 is indeed the "homeopathy tripe", leaving Paper2 as the "conventional tripe" in this round

I thought the audicity of an abstract that includes a noninferiority stat which is not statistically significant and then concludes a demonstration of noninferiority anyway would have thrown more people.

Re: Homepathic or not? Guess the abstract game

David Mills — Fri, 09 Aug 2013 17:22:18 GMT

Paper 1's the homeopathic tripe.

You can pick it from the weasely words and cloak and dagger crap in the abstract:

"symptomatic effectiveness"

all the measures are subjective

"effectiveness was comparable"

And the fact its an open-label, multi-centre trial, I would wager with a fair few vets involved and no case follow-through

What made me really laugh is that in the methods they seemingly had to skew the results by leaving out the owner perceptions and relying on the vets (homeopaths) to judge clinical improvement - which of course, being unblind, they found. Also, the completely arbitrary effectiveness score. And, generally, the complete and utter gobbledegook written in the methods - I had to read it about 6 times just to vaguely understand it.

I thought it was supposed to be a peer-reviewed journal? This reflects arguably more badly on the process rather than the homeopaths who, for years bleating about their medicine not being judged by 'traditional' standards, and now managing to weasel sh*te like this into the ether.

Re: Homepathic or not? Guess the abstract game

Braden Collins — Fri, 09 Aug 2013 16:44:24 GMT

I mean standard not tankard. Damn autocorrect, epecially after having a couple of beers......

Re: Homepathic or not? Guess the abstract game

Braden Collins — Fri, 09 Aug 2013 16:38:02 GMT

I'm going out on a limb and saying neither study meets the double blind randomised control study protocol that is the current gold tankard for proof so I would say that although interesting and worth further investigation neither abstract would lead me to change protocols, treatment or beliefs without further evidence or information. I would concede that homeopathic or not they both sound like further research is indicated but nothing is yet proven.

Re: Homepathic or not? Guess the abstract game

John Flynn — Fri, 09 Aug 2013 12:09:42 GMT

HINT 2: Their approach to noninferiority testing within the paper:

Paper1:

"For the comparison between treatments, noninferiority of [DRUG X] to carprofen was assessed on the primary effectiveness variable and on the veterinarian assessed individual variables. The noninferiority analysis compared the lower border of the 95% CI for the differences in change between the treatments groups. The noninferiority limits were set to 1.5 units for the differences between the primary effectiveness variable (the summary score for the 3 veterinarian evaluated variables) and to 0.5 units for all secondary effectiveness variables. This was not a conﬁrmatory study and thus every individual efﬁcacy and safety criterion was assessed."

Paper2:

"The principal findings of this study are that [DRUG Y] had noninferior efficacy and tolerability compared to carprofen for the treatment of the clinical signs of osteoarthritis in dogs. The relative efficacy of [DRUG Y] was better than for carprofen for the primary efficacy endpoint and all 12 secondary endpoints, although differences were not statistically significant. Statistical noninferior efficacy of [DRUG Y] was shown for only 3 secondary endpoints and not for the primary endpoint, due to wide confidence intervals explainable by a combination of relatively high variability in scores and low sample sizes. For the primary endpoint, the global functional disability score, the relative efficacy of [DRUG Y] versus carprofen was 1.244 (95% confidence interval 0.555–2.493). Therefore, we conclude that the efficacy of [DRUG Y] was at least as good as for carprofen."

Any more takers before all is revealed?

Re: Homepathic or not? Guess the abstract game

John Flynn — Fri, 09 Aug 2013 11:38:10 GMT

Mixed bag so far with 2 votes for Paper1 and one for Paper2 being the homepathic imposter in on our otherwise excellent peer-reviewed literature.

I can't resist throwing in some hints :-)

HINT 1:

Paper 1 was published in the Journal of the American Animal Hospital Association in 2011

Paper2 was published in the Journal of Veterinary Medical Science in 2012

So this is some cutting edge stuff we're looking at - I'm so excited about these results

Re: Homepathic or not? Guess the abstract game

Mark Holmes — Fri, 09 Aug 2013 11:19:51 GMT

Paper 1 is the homeopathic one, no information on how improvement was determined. Paper 2 attempts to quantify the extent of improvement. The term "No inferior efficacy" is the commercial standard by which new products are judged.

Re: Homepathic or not? Guess the abstract game

ceri stewart — Fri, 09 Aug 2013 11:13:30 GMT

But paper 2 says at the beginning it is a "noninferiority design" trial, so that was all they were trying to prove? Paper 2 doesn't seem to say whether it was blind or not , whereas paper 1 is open-label, which I don't like (I expect a sugar-pill only branch might also see improvement under veterinary advice on exercise etc alone). Paper 2 does lots of tests for tolerability, so I guess that's the "proper" drug, whilst paper 1 just looks at adverse events, so I guess that's the homeopathic one?

Re: Homepathic or not? Guess the abstract game

Gerbil — Fri, 09 Aug 2013 10:20:03 GMT

I guess Paper 2 is the homeopathic paper. Reason: the last sentance relates to "no inferior efficacy" obviously written by someone who thinks that he/her has to proove the similar effectiveness of homepathetic medicine imo.

Re: Homepathic or not? Guess the abstract game

Arlo Guthrie — Fri, 09 Aug 2013 09:34:48 GMT

Fascinating.

I'm not being sarcastic. That really is a fascinating exercise.