28 Sep

Where’s the evidence?

Louise Timlin is a Health Economist and mother of two.

When I was pregnant with my first child I was often asked about baby-brain. A colleague or friend would smile indulgently and share a story about how they left their laptop on the train, or their wife put their socks in the fridge while pregnant. I smiled politely whilst I thought to myself, of course no non-pregnant person has ever made such a mistake. One day at work, when I was about 6 months pregnant I inadvertently sent out two invites for the same meeting to the same colleagues but for different days. Oops, I thought and shared my error with my boss who was one of the invitees. He laughed heartily and jokingly referred to my “baby-brain”. On my return to my desk I noticed that everyone invited had accepted both meetings without question, yet none of them were pregnant.

I am sure that baby-brain is simply another example of finding evidence for something if you look hard enough. For example I believe that some people are labelled “forgetful” who are probably no more forgetful than anyone else but every time they make a small mistake it is pounced on as evidence of their intractable forgetfulness.

And apparently I am right, according to a study conducted by Dr Helena Christensen from the Centre for Mental Health Research at the Australian National University. The study, published in the British Journal of Psychiatry, followed a representative cohort of women and measured cognition before, during and after pregnancy. No significant differences in cognition were found, leading to the conclusion that previous studies were flawed or biased.

Dr Helena Christensen said, “Part of the problem is that pregnancy manuals tell women they are likely to experience memory and concentration problems, so women and their partners are primed to attribute any memory lapse to the ‘hard to miss’ physical sign of pregnancy. Not so long ago, pregnancy was ‘confinement’ and motherhood meant the end of career aspirations.”

It may be that pregnancy shifts a woman’s focus away from work, and who wouldn’t forget where they’d left the remote control whilst chronically sleep deprived from looking after a new-born baby. But come on girls, give yourselves a break, you are not cognitively deficient and don’t let anyone tell you otherwise.

Having spent 12 years working in the highly regulated field of clinical research I am not a big fan of “alternative therapies”. Don’t get me wrong, I am a big fan of the placebo effect, just don’t kid yourself it is anything else. If it’s not backed up by evidence from a series of well designed, placebo controlled, regulatory and ethically approved clinical trials then you would do well to be sceptical.

The 1023 group concur. They staged a demonstration at 10.23am on 30th January in which more than 400 homeopathy sceptics took a “homeopathic overdose” in protest at Boots continued endorsement and sale of homeopathic remedies. Homeopathic remedies are hugely diluted substances. They are commonly sold at strengths labelled 6C. This means there is 0.0000000001% of the active substance in them.

There are people who are certain that homeopathy works for them. This is why the most rigorous clinical trials are placebo controlled. In clinical trials for antidepressants, up to 40% of patients taking placebo report a beneficial effect. A paper published in the Lancet in 2005 and the Cochrane Collaboration concluded that homeopathy is nothing more than a placebo effect. Proponents will claim that at worst it does no harm. However even this claim should be treated with scepticism. If patients delay seeking proper expert medical advice whilst using homeopathy to treat their condition, they could risk their condition degenerating. By all means go ahead and try it, but don’t forget, we have medicines that have actually been proven to work; why not give them a go at the same time?

Originally written for the Wokingham NCT Newsletter

Views expressed here are my own, and do not represent the views of NCT.