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The Lancet and the New England Journal of Medicine, two “reference journals”, published two studies within days of each other that led the leading world health authorities to decide on the use of a treatment that could help fight the Covid-19 pandemic. But less than a month later, these studies were withdrawn because they were based more on deception than on the serious science that we might all expect. How did we get from absolute truth to dubious lies?
The race to publish, skimped proofreading, shared beliefs: “Lancet Gate” shows that part of our research is in the hands of a few defenders of the randomized, double-blind, placebo-controlled study. When you say you are using this method, it seems you can publish almost anything as long as the results are in line with current trends. The willingness of the World Health Organisation (WHO) and the enthusiasm of the French authorities to take decisions based only on such publications sends shivers down the spine. And it is symptomatic of fundamental bias that currently prevails: the only things that count are a randomised double-blind study, or a review of the studies published in certain scientific journals.
The only things that count are a randomised double-blind study, or a review of the studies published in certain scientific journals.
However, this method has not prevented a number of significant scandals, for instance those involving rofecoxib or benfluorex hydrochloride. This is also why a non-negligeable proportion of the scientific community, headed by a wide range of doctors, has been saying for several years that it is not possible to use this method alone to generate scientific knowledge. Each person is unique. No patient has a duplicate, even if he/she has an identical twin, so the treatment cannot be given to one and the placebo to the other. The clinician in his/her consulting room or at the patient’s bedside decides the best possible treatment, based on his/her knowledge of the patient’s general state of health, history and symptoms. While the randomized, double-blind study may be of use, it is madness to want to reduce the scope of the research to this methodology alone.
This is an odd reminder of what we saw recently with the denigration of homeopathy. This originated mainly from a so-called “impartial” Australian meta-analysis, which included a “triage” so that only a handful of studies were used to evaluate this medicine. Again, the dogma of the randomised, double-blind, placebo-controlled study was used to exclude any other form of research or approach. And, not surprisingly, the conclusion of this meta-analysis was that there was no study (i.e. no study defined in this totally biased way) demonstrating the effectiveness of homeopathy.
The dogma of the randomised, double-blind, placebo-controlled study was used to exclude any other form of research into or approach to homeopathy.
This masquerade was only the first in a three-act play. The second was the blindness of the French National Authority for Health (Haute autorité de santé – HAS), which swept aside the largest pharmaco-epidemiological study carried out in the last few years, in favour of the cherished double-blind studies. And ignored both testimony from doctors and therapeutic evidence from several million patients. And what was the message? Not that homeopathy doesn’t work, as has been widely reported. But that the results are not sufficient as regards these particular studies. And the media circus is all too evident: a succession of orchestrated leaks at each stage invite commotion rather than reflection. The third act will again be a hasty government decision, making the cost of homeopathic medicines non-refundable across the board, and thus sealing their fate.
In any event, this recent episode shows us that science requires objectivity and debate before we can decide a question and thus establish certainty. Those who have ears to hear!
The Mon Homéo Mon Choix Team