George Lewith

George Lewith is a professor of health research at the University of Southampton, with a strong interest in the research of complementary medicine.

Contents

Background

Lewith graduated from Trinity College, Cambridge in medicine and biochemistry. He then went on to Westminster Medical School to complete his clinical studies and began working clinically in 1975. He had completed his membership of the Royal College of Physicians in early 1977 (elected Fellow in 1992) and completed his training as a General Practitioner and membership of the Royal College of General Practitioners in 1980.

His two main current jobs are professor of health research in the Department of Primary Care at the University of Southampton[1] and vice-chairman of The College of Medicine.[2] Lewith has obtained a significant number of institutional peer reviewed fellowships at doctoral and post-doctoral level and has been principal investigator or collaborator in research grants totally over £5 million during the last decade.[3]

Complementary medicine

Lewith’s publications span a wide range of issues in relation to complementary medicine used as an adjunct to mainstream medicine. This includes methodological papers which look at how complementary medical techniques may be investigated. The first such paper was published in the early 1980s.[4] Since that time he has published papers looking at the clinical effects of acupuncture and its mechanisms, the effects of distant and present healing, the clinical effects of homoeopathy, the effects and activity of herbal medicine, the clinical effects of the Alexander technique and the use and effectiveness of a variety of nutritional supplements and herbs.

He has also investigated how and why people use complementary medicine and is currently involved in two major EU projects. The first is to look at the use, delivery and future research strategy for complementary medicine in Europe[5] and the second relates to the use and investigation of Chinese herbal medicines within a European context.[6]

Research areas

His main research outputs have been across a large number of fields within complementary medicine. They have involved the development of new research methodology to rigorously evaluate these techniques, the collection of primary research data in a variety of fields and the development of new assessment tools through which to evaluate these therapeutic interventions. He has published over 230 peer-reviewed publications and 16 books including various book chapters. He is the lead editor for the standard textbook on the evaluation of complementary medicines which is now in its third edition.[7]

Some examples of the research that Lewith has been involved with include:

His research demonstrates how acupuncture has significant effects over placebo in chronic neck pain[12] and his team has also demonstrated through brain imaging techniques that it has clearly defined neurological mechanisms that are different from placebo.

He has researched how homoeopathic consultations are unique and different from conventional care.[13] His clinical trial of homoeopathy in rheumatoid arthritis indicated that the effect of homoeopathy (almost certainly due to the consultation) is as large as the most powerful conventional drugs available for this condition.[14]

He has also published a number of studies suggesting that various complementary therapies are less effective than placebo for specific conditions. This includes, among many others, acupuncture for disabling breathlessness and a particular homeopathic technique for asthma.

Controversy

Lewith has been criticised because he prescribed homoeopathic treatments when he ran a private practice[15] and an unevidenced diagnostic method, the Vega test. He has written a paper showing that this test was ineffective for diagnosing contact sensitivity (such as cat hair and dust mites) so ceased to use this approach for contact testing.[16][17]

There are a large number of systematic reviews looking at the clinical effects of real versus placebo in homeopathy and analysing much the same data with slightly different research questions and frames of reference. The conclusions of these systematic reviews are evenly split; some suggest that homeopathy is a placebo[18] while others suggest its effect is greater than placebo.[19] All researchers looking at the primary data in this field thoughtfully comment that there is inadequate data upon which to draw definitive conclusions. When such controversies in data interpretation occur it is almost uniformly the case that there is too little information upon which to draw the definitive conclusions.

As someone who has published high quality randomised controlled trials of real homeopathy versus placebo which demonstrate no specific effect[20][21][22] Lewith’s sceptical position in relation to the specific effect of homeopathy is publicly transparent. However all the studies in which he has been involved demonstrate that homeopathy is a very effective treatment even though its efficacy is in doubt. Homeopathy may be exerting these clinical benefits through a variety of mechanisms that have nothing to do with ultramolecular potencies including its unique approach to the consultation.

References

  1. ^ "Complementary Medicine Research Unit member George Lewith". Cam-research-group.co.uk. http://www.cam-research-group.co.uk/details.php?id=1. Retrieved 2011-10-13. 
  2. ^ http://www.collegeofmedicine.org.uk/professor-george-lewith
  3. ^ http://www.cam-research-group.co.uk/introduction.php
  4. ^ Lewith GT and Machin D. On the evaluation of the clinical effects of acupuncture; Pain, 1983, 16, 111-127
  5. ^ "CAMbrella - Communication Platform on topics related to Complementary and Alternative Medicine (CAM) in Europe". Cambrella.eu. 2009-01-03. http://www.cambrella.eu/home.php. Retrieved 2011-10-13. 
  6. ^ "Good Practice in Traditional Chinese Medicine". Gp-tcm.org. http://www.gp-tcm.org/. Retrieved 2011-10-13. 
  7. ^ "Clinical Research in Complementary Therapies E-Book: Principles, Problems and Solutions eBook: Wayne B. Jonas, George Thomas Lewith, Harald Walach, George Thomas Lewith MA DM FRCP MRCGP, Wayne B. Jonas MD, Harald Walach Dip Psych PhD: Amazon.co.uk: Kindle Store". Amazon.co.uk. http://www.amazon.co.uk/Clinical-Research-Complementary-Therapies-ebook/dp/B0058RXL8S/ref=sr_1_1?ie=UTF8&qid=1316719808&sr=8-1. Retrieved 2011-10-13. 
  8. ^ Brien S, Bishop FL, Riggs K, Stevenson D, Freire V, Lewith GT. Integrated medicine in the management of chronic illness: a qualitative study. BJGP. 2011; February. DOI: 10.3399/bjgp11X556254
  9. ^ Randomised controlled trial of Alexander Technique lessons, exercise and massage (ATEAM) for chronic and recurrent back pain. British Medical Journal 2008,337;a884 doi:10.1136/bmy.a884
  10. ^ Little P, Lewith G, Webley F, Evans M, Beattie A, Middleton K, et al. Randomised controlled trial of Alexander Technique lessons, exercise and massage (ATEAM) for chronic and recurrent back pain. BMJ. 2008; 337; 438-441
  11. ^ Hollinghurst S, Sharp D, Ballard K, Barnett J, Beattie A, Evans M, Lewith G, Middleton K, Oxford F, Webley F, Little P. Randomised controlled trial of Alexander Technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain: economic evaluation. BMJ. 2008; 337; a2656 doi: 10.1136/bmj.a2656
  12. ^ White P, Lewith G, Prescott P, Conway J. Acupuncture versus placebo for the treatment of chronic mechanical neck pain. A randomised, controlled trial. Annals of Internal Medicine. 2004; 141(12): 911-920
  13. ^ Burch A, Dibb B, Brien S. Understanding homeopathic decision-making: a qualitative study. Forschende Komplementarmed. 2008; 15: 218-225
  14. ^ (Brien S, Lachance L, Prescott P, McDermott C, Lewith G. Homeopathy has clinical benefits in rheumatoid arthritis patients which are attributable to the consultation process not the homeopathic remedy. A randomised controlled clinical trial. Rheumatology. 2010. doi: 10.1093/rheumatology/keq234
  15. ^ "George Lewith’s private practice. Another case study". Dcscience.net. http://www.dcscience.net/?p=3956. Retrieved 2011-10-13. 
  16. ^ Lewith, GT et al (2000). Is electrodermal testing as effective as skin prick tests for diagnosing allergies? A double blind, randomised block design study. BMJ 322 : 131 doi: 10.1136. http://www.bmj.com/content/322/7279/131.full
  17. ^ Brien S, Lachance L, Prescott P, McDermott C, Lewith G. Homeopathy has clinical benefits in rheumatoid arthritis patients which are attributable to the consultation process not the homeopathic remedy. A randomised controlled clinical trial. Rheumatology. 2010 http://rheumatology.oxfordjournals.org/content/early/2010/11/08/rheumatology.keq234.full.pdf
  18. ^ Shang A; Huwiler-Muntener K; Nartey L; Juni P; Dorig S; Sterne JA; et al. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. Lancet. 2005; 366: 726-732.
  19. ^ Linde K; Clausius N; Ramirez G; Melchart D; Eitel F; Hedges LV; Jonas WB. Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet. 1997; 350: 834-843.
  20. ^ Lewith GT, Watkins AD, Hyland M, Shaw S, Broomfield J, Dolan G, Holgate ST. Use of ultramolecular potencies of allergen to treat asthmatic people allergic to house dust mite: double blind randomised controlled clinical trial. British Medical Jo urnal. 2002; 324: 520-523.
  21. ^ Brien S, Lewith GT, Bryant T. Ultramolecular homoeopathy has no observable clinical effects. A randomized, double-blind, placebo-controlled proving trial of Belladonna 3C0. British Journal of Clinical Pharmacology. 2003; 56: 562-568
  22. ^ Brien S, Lachance L, Prescott P, McDermott C, Lewith G. Homeopathy has clinical benefits in rheumatoid arthritis patients which are attributable to the consultation process not the homeopathic remedy. A randomised controlled clinical trial. Rheumatology. 2010. doi: 10.1093/rheumatology/keq234.)

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