How is a randomized double blind clinical trial done?

Homeopaths say "there's so many different cures for different people for the same illness, how can you compare a drug or a placebo to homeopath?"

Quire simple sunshine. You have 100 people with an illness and treat them with ANY homeopathic preparation you like. Then this will be compared against the 100 people just using, say, water (oh the irony) as a placebo. If homeopathy shows ANY effect above placebo it'll be quite obvious.

(Actually of course this has been done a few times with no benefit shown whatsoever, but homeopaths tend to overlook this).

Some practitioners (at least those believing in TCM) firmly believe that it is "unethical to test something that you know works". And if they have costumers enough they just don't have enough incentive to try and persuade the rest of us that their favourite alternative therapy works better than a placebo. Another theoretical possibility is that a study showing effect beyond placebo would lead to that altie treatment becoming a part of conventional medicine - thus depriving the practitioners of an income. History is full of examples of "absurd" ideas becoming mainstream after scientific documentation.

In all fairness some altie flavours are hard to double blind, because of the way the therapies are given. For instance an acupuncturist will know if he has given real or sham acupuncture - just as a surgeon knows if he has performed a full surgical procedure or just an incision in the skin. That is not an excuse that is useful for homeopaths. That being said there is no reason to believe that a high quality randomised single blinded study can't be performed. As part of such a study design you would have to include some kind of scripting preventing verbal cues as to whether real or sham therapy has been given. In such a study it is a good idea to check if the placebo was credible (For instance by asking the subjects afterwards if they believe they received placebo or treatment).

They have had to find arguments to dismiss properly conducted trials because they show fairly conclusively that homeopathy is a placebo. If they admitted RCTs where a valid way to test homeopathy they would be admitting that homeopathy is fake

@ the witch. Nearly went to a party with the baby dressed as a pumpkin. So cute but in the end we decided to give ourselves a break.

Ok so you would assign subjects numbers and use a random number generator to assign people to your study. Then another group of people would be given the treatments to administer to the subjects of your study, but they would not know what the treatments were. Only the unbiased outside party would know.

I thinks it's not that they don't understand it, I just think that it is easier to manipulate the study if you know whats going on.

Nothing but special pleading and goal post moving. Anything to keep their delusions alive.

Oh, but Dave, you're forgetting that the water could be having an actual effect beyond placebo. You know, like the sham acupuncture where the needles don't penetrate the skin? Perhaps just pushing on the skin has an effect beyond placebo, therefore, acupuncture works!

Wait a minute...that's bullshit. Lost my mind for a second.

Hey Angry.

Oh they understand RCTs and how they work; they just don't like it simply because it shows most of their woo does not work. So instead of accepting their woo is nonsense and discarding it OR coming up with other scientific techniques to investigate their woo, they attack scientific method and RCTs simply because they don't like the results. Childish isn't it?

Alties: If you can come up with a better method of eliminating bias, we are all ears.

Are you going out tonight? I'm just getting ready to go to a Halloween party (wooooooo!)....I'm dressing up as a witch (of course). By the way, Nosey has blocked me from answering his questions. How close minded is that? I'll shoot you my answer to his question, then if you could re-edit, that way he won't be deprived of an answer :) TTYL.

@ Angel: Thats too cute!

See, what a lot of folks don't know is that the first requirement for one of these is the willingness to have your pet theory smashed. Most of the folks who rant-rave-and protest the design of a RDCT are simply more attached to a notion than they are to reality, and lacking in the courage to face the possibility that said notion is malarkey.

Other than that, everyone knows and accepts how they are done. Let's not be silly :)

Now Nate, if you go and say that water has an effect above that of placebo, how long do you think it will take for someone to say "Aha! There ya go! Water has a therapeutic effect on dehydration!" Oops. looks like I already ruined that one for someone...

so randomized double blind clinical trials support the efficacy and soundness of medicine? then why is it such an abysmal failure in the real world? simple. the claims of objectivity and uncompromised scientific method are fraudulent.