No convincing evidence for efficacy of homeopathic care, let alone homeopathic treatment. Kausik Datta, My views are personal and do not reflect those of my institution 10 March 2013 I started reading this paper with interest, particularly since I was intrigued by the assertion by the authors that they wanted to focus on homeopathic care, and not the efficacy of homeopathic remedies per se (an interesting assertion pointed out by someone else). I found this study largely disappointing, scientifically speaking. Several points have been discussed in the blog this hyperlink points to. I made a few additional observations which indicate, to me, that this paper did not present convincing evidence for efficacy of homeopathic care as well. I am slightly leery of using quality of life (QoL) measurements as a study variable. I am, of course, speaking from a privileged perspective, in that my definition of 'quality of life' (as a reasonably healthy individual) and a cancer patient's definition of the same are bound to be dramatically different. But that difference, then, would directly speak to the difference in the perception of the efficacy of these alternative medicine ('alt-med') therapies between, say, my taking them and a cancer patient's taking them. Surely that would impact a survey-based QoL measurements? As others (most recently, Prof. Edzard Ernst) have discussed, it is likely that the creation of a feel-good factor is the principal goal of the alt-med therapies - which may even account for some of perceived efficacies of alt-med therapies. But, by that count, non-conventional approaches like Therapy Dogs are equally effective. Which means, there is no specificity of these alt-med treatments, if QoL is to be the sole arbiter. An important point regarding the randomization mentioned in the article being discussed. Patients were not randomized in a blinded fashion. They chose homeopathic or conventional treatment. At entry, homeopathy patients were younger, more educated, and were more likely to be white collar workers or in self-employed jobs. Coming as they were from socieities in which homeopathy is accepted as a valid method of treatment, is it any wonder that the homeopathy arm would do better in the QoL surveys? The capacity of human beings to delude themselves is almost endless. This is one of the reason why these subjective estimates are very problematic. I'd have loved to see some objectively assessable diagnostic and prognostic information, such as, say, tumor status and progression, histopathology data, and so forth, which were not included in the paper. Another question jumps to the mind. What was the placebo? I mean, after the randomization, in order to judge the efficacy of homeopathy over placebo, the patients would have to get exactly identical treatment (including interactions, conversations and palliative care) except for the variable being tested. From my reading of the paper, it appears that it was only homeopathy or no homeopathy. The authors refer to a book and a paper for the treatment regimens. Unfortunately, it is beyond my capacity to read non-English text. I couldn't even find the abstract of the paper in PubMed. Finally, it is good that the authors have consciously refrained from comparing the homeopathy arm and the conventional arm (as they indicate in the discussion). Else, the consistently higher proportion of death in the homeopathy arm (I cannot speak to the statistical treatment, not having the raw data at hand) would have required some explanation. So, overall, even if the authors say that they focus on 'homeopathic care' rather than on 'homeopathy remedies', this paper doesn't seem to address many of the pertinent questions. Competing interests I have no competing financial interest. However, I am skeptical of homeopathy as a valid medical therapy and have written on that subject at various fora.