All evidence is equal, but some evidence is more equal than others: can logic prevail over emotion in the homeopathy debate?

2 In his classic political satire Animal Farm, George Orwell described a fantasy world in which having total power gradually corrupts and distorts the initially idealized societal commandments articulated by the farm animals who have successfully risen up against a common enemy, i.e., the farmers (people). In the end, the commandment that " all animals are equal " drifts into " all animals are equal, but some animals are more equal than others. " Unfortunately, allopathic medicine, i.e., conventional mainstream medicine in its politically dominant position, has reached an analogous juncture in its history of considering evidence. The recent Shang et al. meta-analysis study (Shang 2005), and the accompanying editorials pronouncing the " end of homeopathy " (Lancet. 2005) and the " growth of truth " (Vandenbroucke 2005a) in the prestigious British journal Lancet expose an Orwellian selectivity and bias in considering facts, as well as an illogic, under the aegis of " evidence-based medicine. " The Shang et al. paper concluded that " the clinical effects of homeopathy are placebo effects " on the basis of 8 unspecified homeopathic studies and 6 unspecified conventional (allopathic) studies out of an original total of 110 studies of each type on the same variety of conventionally-diagnosed conditions. The editorial stance raises grave concerns about logic, fairness, and rationality in the Lancet's interpretation and use of the evidence, for several reasons: • The subanalysis on which the main conclusions are based did not specify which 8 papers out of the original 110 homeopathic or 6 papers out of the original 110 allopathic papers were used. This type of lack of reporting transparency and precision is typically not tolerated for allopathic medical reports. For instance, the CONSORT statement requires a full disclosure of outcomes of all initially enrolled patients in a detailed flow chart (Altman et al. 2001); but the lack of comparable details was tolerated for the identity of the small number of actual studies used for the Shang et al. meta-analysis conclusions. • The Shang et al. paper report is one meta-analysis out of several published meta-analyses (the others have been largely favorable to what they claim is " homeopathy " 3 (Cucherat et al. 2000; Linde 1997; Reilly et al. 1994)), based on an incomplete and not-up-to-date selection extremely heterogeneous RCTs encompassing multiple different allopathic diagnoses and using interventions that are only sometimes considered homeopathic by homeopaths. That is, isopathy (using …