A dubious homeopathy study made its way into a scientific journal. Will it be retracted?

Homeopaths did it again–they snuck a dubious study into a respectable journal. Well, sort of. Let's quickly look at the study, and then look at the journal that published it.

The paper has a very science-y sounding title, which likely helped it sneak under the radar: "Ultra-diluted Toxicodendron pubescens attenuates pro-inflammatory cytokines and ROS-mediated neuropathic pain in rats." It seems they were studying pain in rats, but what else is hiding inside this title?

The first warning here is the phrase "ultra-diluted." In the world of homeopathy, substances are diluted until there is literally nothing left, not a single molecule. Some of the dilutions in this paper were indeed extremely dilute, down to 10-30, which means that they were just water. So they can't possibly have any therapeutic effect, at least no more effect than plain water.

You might also be wondering what Toxicodendron pubescens is. That's poison oak! Here's what homeopaths claim about poison oak: that if you dilute it down sufficiently, it reduces itching and pain. This is one of the basic principals of homeopathy, that "like cures like"–that if you want to treat a symptom, using a substance that causes the same symptom, only dilute it way down. Feeling itchy? Rub some poison oak on that! I'm not kidding–here's a link to a product you can buy that really makes this claim.

Of course this is utter nonsense, as I and many others have written before. Homeopathy doesn't work for anything at all, as a massive Australian study concluded back in 2015.

Now let's look at where this dubious study appeared: in a journal called Scientific Reports. Scientific Reports is a mega-journal that publishes 25,000 papers per year, making it the largest journal in the world. What's also interesting is that it is published by the Nature publishing group, which also publishes the highly prestigious journal Nature and many other related, high-quality journals. (Full disclosure: I've published many papers in those journals.) PLoS ONE was the first mega-journal, and it was so successful (i.e., it made so much money for its publishers) that Nature decided to imitate it. They've managed to steal a lot of the "customers" from PLoS ONE because the Nature brand is, apparently, more appealing to many authors.

It's tempting to argue that everything in Scientific Reports is just low-quality stuff, so one more bad paper doesn't mean anything. But it's not so simple. Scientific Reports is trying to be a decent journal, one that has a very high acceptance rate (59%, according to their website) but that nonetheless publishes only valid science. Last year I was involved in a kerfuffle with them over a plagiarized paper, and after lots of pressure, we did get them to retract the paper. It wasn't easy, but the Editor in Chief corresponded with me at the time, and he really does seem to be trying to enforce some decent standards.

When you publish 25,000 papers a year, though, some garbage is going to slip through. To their credit, Scientific Reports has now issued a note of concern on this homeopathy paper, as reported by the alert team at Retraction Watch. Here's the note in its entirety:
"Editors’ Note: Readers are alerted that the conclusions of this paper are subject to criticisms that are being considered by the editors. Appropriate editorial action will be taken once this matter is resolved."
The right thing to do would be to retract this paper, because its results are simply not valid. We'll see if that happens.

Meanwhile, when reading the paper, I noticed that no less than eight of its references are to a journal called Homeopathy, published by Elsevier, one of the biggest and most profitable academic publishers in the world. Unlike Scientific Reports, Homeopathy is not even trying to publish valid science; its entire existence is premised on a nonsensical set of beliefs.

The good folks over at Retraction Watch wrote about this journal two years ago, in an article called "Does a journal of homeopathy belong in science?" Spoiler alert: it doesn't. As Ivan Oransky and Adam Marcus wrote then:
"the issue is that science publishers, even legitimate global corporations like Elsevier, will accept something patently unscientific if it might make them money."
So while Nature does deserve criticism for letting bad science slip into its mega-journal, Elsevier has a lot more explaining to do. At least Nature is trying.

World Health Organization endorses TCM. Expect deaths to rise.

Mother and young rhinoceros killed for their horns.
Image credit: Wikipedia
A few days ago, a news story in the journal Nature reported that the World Health Organization, which is supposed to be devoted to improving the health and medical care of people around the globe, will for the first time endorse a belief system called "traditional Chinese medicine." I'm labeling TCM a belief system because that's what it is–but the WHO will be endorsing it as a set of medical practices.

The Nature writer, David Cyranoski, presents this news in a classic two-sides-of-the-story format, describing the "endless hours" that TCM proponents spent on such important topics as the "correct location of acupuncture points and less commonly known concepts such as ‘triple energizer meridian’ syndrome." Later in the article (but much later), he points out that scientists have argued that qi and meridians simply don't exist.

Cyranoski also falls into the trap of using the phrase "Western medicine" as if it were just an alternative point of view. An apt response is this comment from a biology Ph.D. student, who goes by @astrelaps on Twitter:
"What a weak, equivocal article from the world's preeminent scientific journal. "For those steeped in Western medicine..." is like writing "For those steeped in climate science" or "For those steeped in evolutionary biology" when reporting on climate change denial or creationism."
Well put. On the other hand, Cyranoski does point out that the major motivation for TCM is money:
"[China] has been aggressively promoting TCM on the international stage both for expanding its global influence and for a share of the estimated US$50-billion global market."
Were you thinking this was about health care? Afraid not. Cyranoski goes on to point out some serious problems with TCM, for example:
"Critics view TCM practices as unscientific, unsupported by clinical trials, and sometimes dangerous: China’s drug regulator gets more than 230,000 reports of adverse effects from TCM each year."
Actually, it's much worse than this.  Here's what TCM really looks like: the horrific slaughter of the last remaining rhinoceroses in Africa in order to hack off their horns, which are sold to become part of elixirs that some people mistakenly think confer strength or virility. Last year, National Geographic ran a heart-wrenching photo essay showing some of the awful results of rhinoceros poaching in Africa; take a look at these photos here.

TCM also looks like this: black bears kept in grotesquely cruel "farms" with a permanent tube inserted into their abdomens so that their bile can be harvested. Despite a growing movement to end this inhumane practice (see this NY Times story), it persists today, with thousands of bears kept in cages so small they can barely move. No one can view photos such as these and say that TCM is a good thing.

And TCM is behind the slaughter of the last remaining wild tigers, which are virtually extinct now in Asia, so that men can foolishly eat their bones, claws, and genitals in the mistaken belief that tiger parts will make them virile. Here too, National Geographic has details and photographs that are almost too painful to look at.

And don't get me started on pangolins, the beautiful, peaceful mammal that's now perilously endangered because TCM practitioners think its scales have some sort of medicinal value. (They don't.) For more on these gentle creatures, see the article I wrote last year.

I can almost hear the counter argument: but what about artemisinin? That's a plant extract derived from Artimisia annua, an herb that was traditionally used in China to treat malaria. Turns out that it really works, and artemisinin is now the basis of a number of modern malaria treatments.

Well, great. If an herb has the potential to treat disease, we should (and can, and do) study it, figure out what the active ingredient is, develop a controlled process for delivering effective doses, and use it. That's what happened with artemisia, and it also happened with taxol, an effective cancer chemotherapy derived from the Pacific yew tree, and common aspirin, derived from the willow tree.

But one success doesn't excuse hundreds of bogus claims that are based on little more than magical thinking.

There's no legitimate reason to use terms such as "Chinese" medicine, or American, Italian, Spanish, Indian, or [insert your favorite nationality] medicine. There's just medicine–if a treatment works, then it's medicine. If something doesn't work, then it's not medicine and we shouldn't sell it to people with false claims. The same is true for alternative, holistic, integrative, and functional medicine: these are all just marketing terms, with no scientific meaning. They merely serve to disguise sloppy, unscientific thinking at best, and in a less charitable interpretation, outright fraud.

As the Nature article points out, TCM has been a scam for decades: it was revived and heavily promoted in China by former dictator Mao Zedong, who didn't believe in it himself, but pushed it as a cheap alternative to real medicine. I won't go over that again here, but see these stories from Alan Levinovitz in Slate and David Gorski at Science-based Medicine.

Finally, why would the World Health Organization start pushing a set of unscientific practices that are likely to harm people's health? Support for TCM grew during the tenure of former WHO director Margaret Chan, who ran the WHO until 2017 and who had close ties to China. When Nature tried to contact Dr. Chan, the WHO responded that Chan "is not answering questions on matters related to the WHO."

By endorsing TCM, the WHO is taking a big step backwards. Let's hope that the current leaders of the WHO will realize that this step undermines their core mission. The WHO should not advocate treatments that not only have no evidence to support them and that can cause real harm to patients, but also are the primary reason that humans are hunting rhinoceroses, tigers, pangolins, and other animals to extinction.