Letter I sent directly to Dr Wayne Jonas as a reply to his "reply" [I have not been fortunate enough to get a reply to this letter yet]. It follows below. Best regards, Renan M Almeida *** Dec 2003 Dr Jonas, I have read your reply (Jonas 2003) to my comments in Ann Int Med (Almeida 2003). I understand that the "letters" section of Ann Int Med does not provide sufficient space for a full discussion of these topics. Below I have some further comments, and I would be interested in your opinions on them. 1) In summary, in my comments I made the following points: a) homeopathy uses an absurd classification scheme, as illustrated by my comment on the Pulsatilla prescription "signs" b) in homeopathy, papers with better quality yield less positive results (a fact I am certain that you are well aware of) c) There have been no independently replicated, quality studies in homeopathy. Could you please elaborate in what sense the above comments "fail to assess treatment model validity" and "lead to erroneous research evaluations"? 2) Concerning my comments on Jacobs et al 1994, the paper you mentioned (Vickers 2000) did not address important criticisms of it, namely, the very marginal p-values involved, the careless recording/reporting of results and the alfa-level inflation by multiple comparisons. In fact, the main point that Vickers et al 2000 addressed in their "debunking" (as you called it) was that the peculiar homeopathic classification scheme could only decrease the significance of results, not increase it. This assertion is in general correct, but see below (by the way, I did not concern myself with the first of the three diarrhea papers you mentioned, since admittedly that was a "pilot" study). 3) Concerning homeopathic classification schemes, the peculiar "symptoms" that homeopathy uses for "diagnosis" only help to show how absurd it is. What it seems obvious is that if a classification scheme is patently invalid it either has to be radically changed, or abandoned. Thus, the statement that the use of an absurd classification scheme is not something to worry about, since it could not improve results, seems to me illogical and erroneous. Are you aware of any scientifically valid justification for the use of a classification scheme such as the Pulsatilla example I described? 4) Finally, I apologize for my mistake in attributing a US$ 50 000 0000 figure for the amount the NCCAM had available for CAM research. I realize now that the amount is much smaller, a mere US 25 000 000 maybe? Renan M Almeida, PhD References Almeida RM. A critical overview of homeopathy. Ann Intern Med. 2003 Oct 21; 139(8). Jacobs et al. Treatment of acute childhood diarrhea with homeopathic medicine. Pediatrics 93(5) 1994 719-725 Jonas W. A critical overview of homeopathy. Ann Intern Med. 2003 Oct 21;139(8). Vickers AJ. Clinical trials of homeopathy and placebo: analysis of a scientific debate. J Altern Complement Med. 2000 Feb 6(1):49-56. ***** Prof Renan Moritz Varnier R Almeida, PhD Coppe - Federal University of Rio de Janeiro Program of Biomedical Engineering Caixa Postal 68510 Cidade Universitaria tel (021) 25628583 Rio de Janeiro RJ 21945-970 Brazil Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.