Popularity does not mean effectiveness or sensibility

By Grant Jacobs 26/01/2010 15

In recent comments to an article I wrote on homeopathy in New Zealand pharmacies, some readers suggested that because the remedies were popular, they must be OK.

Buried Alive - BondesonTo give a little light relief from the weightiness of the topic, let’s illustrate the illogic of using popularity in lieu of demonstration of effectiveness by paradoxially considering the morbid example of mausoleums.

Previously I reviewed Bondeson’s book Buried Alive. (There’s also a video of Monty Python’s “Bring out your dead” skit, if you’re a fan.) If you read the book, you’d learn that mausoleums where once popular in Germany.

These mausoleums were institutions set up throughout Germany to ensure that the dead really were dead by babysitting them for several days.

To their credit at least they kept good records, as German administrations seem to have a reputation to.

After a number of years, they realised that no-one was recovering from death, so the mausoleums themselves died.

From this we get two lessons:

  1. No-one survives death (Good lesson, that!)
  2. Just because something is popular, doesn’t make it effective or sensible

More articles at Code for life:

Map shows New Zealand with lowest death rate on earth in 1856, over 11 in 1000 dying

Deleting a gene can turn an ovary into a testis in adult mammals

All this talk about 3-D movies and TVs is depressing

Scientific baking. Great for those lab meetings or kids’ parties

Explore ancient science books on-line

(I apologise for the inexcusably short post, but that’s the all time I have tonight…! I will return to the homeopathy articles in time. I have nothing against Germans and there are some fine German scientists and scientific institutions.)

15 Responses to “Popularity does not mean effectiveness or sensibility”

  • Of course the other reason they may be popular is that the people who buy and use them find them useful. As with a number of the other so-called sceptics yours is the usual position that people are stupid and they need highly intelligent people like you to point that out to them. Your example is spurious to say the least – and by the way homeopathy is extremely popular in Germany, both with patients and doctors who practise in in their thousands, fine ones too. One more reason for the decrease in mausoleums perhaps!

  • The point is you have to say more than just “it is popular”.

    Likewise pointing at the number of people that buy something, doesn’t make is a sensible or effective thing to buy; you need to show that the thing is effective or sensible. People buy silly things with a little marketing encouragement!

    Demonstrating that the remedies are effective would help. (i.e. more than hearsay.)

    I’m aware homeopathy is popular in Germany; that popularity in itself cannot say it is effective or sensible. Evidence-based studies might, except these don’t support any effect beyond placebo.

    The example I gave works in hindsight. At the time people thought it a sound idea. We now think it’s silly. Just goes to show how gullible perfectly good people can be when they don’t look to evidence.

  • rainman,

    Just a head’s up: I’ve a mind to block comments with no real content or substance. Discussions are fine, but this isn’t the place for throwing brickbats.

    If you have something substantive to say by all means go ahead. (I’d suggest you read my reply to Stephen first.)

    Just nipping this in the bud, as I don’t want this style of thing to be a trend on my blog.

  • Grant,

    Perhaps you overlooked the little smiley thing at the end of the sentence. Here’s a hint for you in return – read it and imagine me smiling and shaking my head in wonderment that you might think the article above is actually a rebuttal to the discussion we’ve had to date. Or even particularly logical!

    The issue is not popularity, and to suggest that the counterargument to your initial post is “if it’s popular it’s OK” is a strawman; I don’t even hold that homoeopathic medicines are popular – I have no hard stats to back this up but my guess is when most folks get a cold they reach for the codral, sinutab, or whatever we’re allow to buy these days without being suspected felons.

    Further, my argument isn’t that alleged popularity makes them “OK”, whatever that means. My point is that they do no direct harm, and thus fall into he category of stupid things that people are entitled to do, using their own, albeit possibly misguided, free will. Stephen’s already pointed out (far more politely than me) the inherent arrogance in your approach.

    The thing is, we all have different senses of what is effective, and even different value systems that inform these. Not everyone values the evidence, some are more informed by religion than science: Darcy’s post lined to the case of the couple in Australia who didn’t treat their child for eczema – have a read of that linked article (particularly the last para) and explain to me again how you would suggest that he adopts your value system and epistemological approach?

    I have some examples which may clarify further but this comment is getting too long already so I’ll post them in Darcy’s thread.

  • rainman,

    It isn’t a “rebuttal” to anything, nor an extension of earlier posts despite the idea for it coming from comments in an earlier post. It’s “little light relief from” the topic. (2nd paragraph.)

    Why do you assume this post is a “reply” to you or anything you said? It’s not. Besides, you’re not that important! 😉

    You seem to have entirely missed the humour in your determination to hit on me. Could I suggest you not spoil the fun for others?

    None of what you’ve written addresses what I wrote: I wrote with respect to effectiveness and sensibility, not people’s choices, religions or value systems. I’m not eating the red herrings 😉
    (Nor the misleading labels.)

    Food for your thought all the same: that others’ have different bases for judging things doesn’t mean their way of judging things is effective or sensible. Things become effective and/or sensible when they’re grounded in reality, hence the use of evidence-based approaches.

    If religion and value systems is your interest, I you recommend Ken’s blog, Open Parachute, which covers that (I don’t): http://sciblogs.co.nz/open-parachute/

  • Grant, my apologies – I thought you wanted a discussion on the validity of your views, as expressed across two posts, regarding homoeopathic medicines and whether they should be in pharmacies or not. I’m certainly not determined to “hit on” you – (why would I, when I don’t even know you?) – but merely don’t agree with your view that pharmacies should only sell things that have been proven to work. That this view was stated on a public blog accepting comments is a generally accepted clue that it’s open for debate. Y’know, you state a thesis, the great unwashed out here in comment-world come back with counters, entertainment and mutual education ensues… Blogging isn’t the same as a one-to-one discussion, in several meaningful dimensions.

    If this isn’t actually a forum for such debate, I’ll wish you good day and be off. Assuming it is, though…

    I do agree that homoeopathic remedies are a nonsense, so I’m not debating the issue of effectiveness. The bit about “sensibility” – and what to do about it – is where we diverge. I largely agree with your 2nd last para, believe it or not – despite it sounding like an expression of assurance that you are right, in absolute terms. I have some science training and favour an evidence based approach to most things. But my response would be, “so what”?

    Here’s the key point I’m making – and where value systems come in – not everyone thinks like this (e.g. the bloke in the article linked by Darcy). “Sensible” is an intrinsically value-laden term, relating to decision and sound judgement. Deciding on treatment involves experience, trust, political opinions about the pharma and medical industries, religious and spiritual views, etc. And yes, sometimes direct assessment of scientific evidence, although indeed not often enough. The reasoning behind this decision process are far more complex than the view expressed by your posts allows – perhaps in that cartoon world it would be OK to restrict pharmacies from selling certain preps, but not in this reality.

    My question in response to your posts is, essentially: what right do you have to restrict the choices of others to make misguided but harmless decisions? What if the harm is for their account only?

    (And I contend the indirect harm response doesn’t hold up – people do things all day long that are indirectly harmful to themselves and others. It would be a different world indeed if we restricted all of these activities).

    Btw, I do read Ken’s blog – as it comes in on the sciblogs feed – but my interests are broad, and debating religion qua religion is boring! Not that that is all Ken talks about…

  • rainman,

    I would have thought that my hint that was a relief from that topic might have prompted you to comment in the appropriate thread. I guess that’s too subtle. I would prefer homeopathy to be in the homeopathy thread, please. I don’t like this sort of thing polluting my other comment threads. I’m taking the remainder of my reply over there. (When I get around to it.)

  • There is the old anachronism that an absence of evidence is not evidence of absence. Yes there is little evidence that may homeopathic/natural rememedies work. However, research in to these treatments is underfunded compared to mainstream health and difficult to do becuase of not knowing what the actual thing is that may be causing the effect (if any). One must also remember the many pharmaceuticals that have been developed from natural chemicals from anticancer to heart drugs.

  • Leapy99,

    1. And equally it’s true that the burden of proof of a claim of a remedy lies with the company/seller/whatever making that claim, not for others to “check”! See also: http://sciblogs.co.nz/code-for-life/2009/10/18/health-remedies-burden-of-proof-lies-with-seller/

    2. This article is about a general point relevant whenever “the argument from popularity” is used, not just in the case of homeopathy. There is no evidence for homeopathy beyond placebo, but that’s the topic of the earlier post, not this one.

    3. Citing natural sources as sources of treatments while true it and of itself is besides the point in that it wouldn’t justify homeopathy or any other untested product. The relevant point is demonstrating that they work before people make claims that they do. I’ve written about this before elsewhere. (Haven’t time to dig it up, hunt around.)

  • Sorry, Grant, I know I’m a bit off-topic! Leapy99 – research into homeopathy is actually fairly easy to do & a number of studies now suggest that its effects are no better than placebo. (The bigger & better-designed the study, the more the remedy’s effectiveness approximates placebo.) Ben Goldacre & Andy Lewis (the Quackometer) have both blogged extensively on this. As for funding, NICCAM in the USA has poured some millions of dollars into research into ‘complementary & alternative medicines’ (including homeopathy), so far with few if any indications of their effectiveness. Yet the authors of these studies continue to conclude that ‘more research is necessary’.

  • Hi Alison,

    Don’t mind, as long as people are aware it’s not limited to homeopathy, but is a more general point about a far wider range of things. Besides the comments seem to have taken on their own independent life… :-)

    Perhaps the easiest research is simply to measure what’s in the bottle or pills? Comes back to a main theme of my previous article: accurately labelling of the contents.

    Good point about funding for the NICCAM work. They produced a summary statement a year or two ago saying that over ten years of research little had shown to have any effectiveness. I would still rather see that work funded by those producing the products (perhaps by some kind of tax scheme?), but maybe it’s for the better in the end that someone does it seeing that the “natural remedy” industry seems to have little inclination to test their proposed remedies before making claims about them.

  • My favorite example of something that was popular but worse than useless is bloodletting. This was believed by very many people for thousands of years to be an effective treatment for more or less everything. Eminent and otherwise skilled doctors, such as Benjamin Rush, were staunch supporters of bloodletting. Even when crude clinical trials showed that it greatly increased mortality, Rush refused to believe it was ineffective.

    The important thing to learn from this, and the mausoleums, is not that “people are stupid” but that we are all very good at coming to the wrong conclusions from limited evidence. Even the most intelligent of us can fool ourselves into thinking that a homeopathic remedy is working (or in earlier times that hundreds of people are being buried alive). That’s why we need carefully gathered evidence like clinical trials to check if we are fooling ourselves or not.

  • Krebiozen,

    Thanks for the thoughts and example. Have you read Holly Tucker’s book Blood Work: A Tale of Medicine and Murder in the Scientific Revolution?

    I probably add here that according to Bondeson at the time of the mausoleum ‘fad’ in Germany doctors could determine death well, and that the origins of this and related fads at least in part lie with Allan Edgar Poe’s work and derivatives.

    Given it’s ancient origins (I’ll take you word for it), I wonder if bloodletting more properly belongs in the ‘Argument from Antiquity’ camp, another common fallacy associated with ‘natural’ remedies, rather than argumentum ad populum (argument from popularity) which I was introducing here.

    Either way, it certainly is an example of (continuing) doing something in the face of evidence suggesting otherwise. (On that note, I just have to point out that both are still fallacies in the absence of evidence against them, as they’d still be a false argument for the proposed treatment. Pedant 😉 )

    “The important thing to learn from this, and the mausoleums, is not that “people are stupid” but that we are all very good at coming to the wrong conclusions from limited evidence.” […] That’s why we need carefully gathered evidence like clinical trials to check if we are fooling ourselves or not.

    Absolutely, although you could argue that we have less excuse for committing these errors today given that education is widespread, etc. It’s one reason I and others feel that introducing critical thinking into education is very important.

    I’m hope readers realise I’m not pointing at people (i.e. ad hominem) but atargumentum ad populum.

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