“The Plural of Anecdote is Data”

Once upon a time… but no, hold on.  Every homeopath, every patient, can give many ‘anecdotal’ reports of treatment success.  So what is an anecdote?  “a narrative of […] a single event […] in itself interesting or striking”.   In terms of someone’s experience, what’s wrong with that?  And when is an anecdote not an anecdote?  When it’s qualitative research.  Or as political scientist Raymond Wolfinger said, “the plural of anecdote is data”.

Statistics rule modern medicine, seemingly – yet much of the information that shows what patients and healthcare professionals do and experience derives from qualitative research.  That’s when a group of individuals is given the space to talk about their personal experience, embedded in a formal piece of research.  Large quantitative studies lack the instruments to capture such information, and healthcare providers are happy to use qualitative data to assess quality of care, including outcomes.  But in science ‘anecdotal’ is a dirty word: it implies value-less, baseless assumptions, wishful thinking, deliberate charlatanery – so is favoured by skeptics when discussing ‘implausible’ modalities.

Until about fifty years ago, humanity’s medical evidence base derived largely from experience and observation.   Yet modern medicine is a development of what went before, not a grail that sprang, new- forged, from a sudden realisation that all that had gone before was false.  There have always been theories: humours theory, spagyrics and hundreds more.  Our medical model, amazingly, stands on the ancient shoulders of Galen and Avicenna as much as Koch and Pasteur – and it is just as much based on theories.  Because new, we trust today’s theories to be true.

But seemingly scientifically well-founded ‘best practice’ often enough turns into its opposite.  Much like Delia’s latest ‘superfood’ promotions, it changes all the time:  Take aspirin daily, it will save your life.  Don’t take aspirin – it doesn’t prevent heart attacks, it makes your stomach bleed.  And aspirin, like vast numbers of modern medicines, originates in ‘superstitious’ folk medicine: pharmacists learnt to synthesise the active ingredient of willow bark in the 19th century, one of the earliest pharmaceutical best-sellers.  Did it matter that Culpepper 300 years before thought willow was ‘ruled by the moon’?  He knew how to use it – for pain and fever, as today – from handed-down folk experience: anecdote.

© David Davies 2009

Homeopathy works.  A bold statement – from my own experience and the experience of millions who have been helped, often saved, by homeopathy. One chestnut skeptics like to hurl invokes an analogy between the millions who ‘believe’ in homeopathy and the masses adhering to faith and religion.

The difference: faith in the existence of a higher being is necessarily just that: the ability to have faith itself is a predicate of faith.  Philosophers  of all schools argue the essential unknowability of divinity.  In homeopathic treatment, the patient need not ‘believe’ in the method, may not know they are receiving treatment (babies, coma patients), may be extremely sceptical: the most fanatical homeopathy-denier will still benefit.  Few expose themselves to such a risk of challenging cherished beliefs, not to mention loss of a close-knit community. Like leaving the church for a Catholic, only on the internet?

So what’s the proof of my anecdotal pudding?  Even some homeopathic researchers propose that ‘the consultation’ may be the key to success.  But no: in many settings, the consultation is no longer or ‘nicer’ than the average GP appointment.  Overall, homoepathic treatment outcomes are comparable, no matter interview style and length (across the board, around 85% of homeopathic patients improve significantly in vastly varied treatment conditions).

While, just as in ordinary medicine, other explanations may apply in a proportion of cases – natural resolution to an acute episode, sudden remission of serious illness – the sheer mass of direct reporting of homeopathic successes speaks for itself: not every cure can be explained away, not every patient is a gullible fool, by the million, worldwide.  People understand this, otherwise homeopathy would have long-since been consigned to the quack-heap of history.

Key factor: if the wrong remedy is prescribed, the patient doesn’t improve; once the right prescription has been found, the patient’s health changes.  Wrong remedy = no cure, right remedy = cure – no matter the belief of patient or practitioner.  It’s when homeopaths get it wrong that the crucial importance of the remedy shows itself – if the remedy were ‘only’ a placebo, the actual prescription would make no difference.  We may not know why medicines at such high dilutions work, but we can see their effect on health, directly and patently.  Patients and practitioners everywhere tell us so – whether you want to call that data or anecdote.

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2 responses to ““The Plural of Anecdote is Data”

  1. Thanks for your comment. I’m afraid what you say is a standard skeptic fallacy based on assumptions and lack of first-hand experience. If you work with homeopathy day in, day out, it becomes absolutely obvious that ‘natural progression’ and ‘self-limiting ailments’ cannot possibly apply all of the time, in every single patient, all over the world – ditto the ‘it’s just placebo’ assumption. Judging and condemning homeoapthic practice without direct clinical experience, without watching patients and their responses, is easy. The reasons why RCTs are problematic in homeopathy have been widely discussed: please see Clare Relton on this in particular, and not least her work on feasibility of research into homeopathic treatment under EBM; I recommend the Homeopathy Research Institute for further information. Funding is the problem, not the research.

  2. In the case of homeopathy, you fail to take into account the natural progression of self limiting ailments. Trying remedies until something works may just be the ailment resolving by itself. This is why the “RCT” is a better method.