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Review of Positive and Negative Homeopathic Trials Alastair Gray Homeopathy Department © Endeavour College of Natural Health endeavour.edu.au Homeopathy Department Endeavour College of Natural Health

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Page 1: Review of Positive and Negative Homeopathic Trialsmphm.com.my/wp-content/uploads/2017/04/Alastair Gray.pdfthings that do not make sense. Overview of Positive Trials o Carlston, M.,

Review of

Positive and Negative

Homeopathic Trials

Alastair Gray

Homeopathy Department

© Endeavour College of Natural Health endeavour.edu.au

Homeopathy Department

Endeavour College of Natural Health

Page 2: Review of Positive and Negative Homeopathic Trialsmphm.com.my/wp-content/uploads/2017/04/Alastair Gray.pdfthings that do not make sense. Overview of Positive Trials o Carlston, M.,

Introduction / Contents

o Who?

o Review the Positive Trials

o Review the Negative Trials

o Understand the arguments

© Endeavour College of Natural Health endeavour.edu.au

o Understand the arguments

and the perceptions

Page 3: Review of Positive and Negative Homeopathic Trialsmphm.com.my/wp-content/uploads/2017/04/Alastair Gray.pdfthings that do not make sense. Overview of Positive Trials o Carlston, M.,

Positive Homeopathy

o +++++

o Homeopathy is the second

most popular CAM in the world

o 550 million users

o - - - - - - -

o Despite this - significant

opposition

o Belfast homeopathy results -

effects of ultra-dilute solutions of

© Endeavour College of Natural Health endeavour.edu.au

o Practiced in 41 out of 42

European countries.

o Interest in CAM increasing

o Interest in Homeopathy is

holding its own

o Cost effective and safe

o Cheap and Sustainable

o Different business model

effects of ultra-dilute solutions of

histamine on human white blood

cells involved in inflammation. The

study, replicated in four different

labs, found that homeopathic

solutions - so dilute that they

probably didn't contain a single

histamine molecule - worked just

like histamine.

o Brooks, M., New Scientist 13

things that do not make sense.

Page 4: Review of Positive and Negative Homeopathic Trialsmphm.com.my/wp-content/uploads/2017/04/Alastair Gray.pdfthings that do not make sense. Overview of Positive Trials o Carlston, M.,

Overview of Positive Trialso Carlston, M., Published

human trials of Homeopathy,

Classical Homeopathy,

Churchill Livingstone London

2003.

o Dean, M., The Trials of

Homeopathy, 2006,

Appendixes 1-4,

© Endeavour College of Natural Health endeavour.edu.au

Appendixes 1-4,

o Fisher, P., Research in

homeopathy: an annotated

bibliography, Research in

Homeopathy – A Bibliography

Compiled and Annotated by

Dr. P. Fisher, 8th edn. Royal

London Homeopathic Hospital,

1991

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Overviews

o An Overview of Positive

Homeopathy Research and

Surveys, European Network

of Homeopathy Researchers

(ENHR) April 2005.

Republished The European

o Jonas WB, Kaptchuk, TJ,

Linde, K., A Critical Overview

of Homeopathy:

Comprehensive Systematic

Reviews of Clinical Trials of

Homeopathy on the General

© Endeavour College of Natural Health endeavour.edu.au

Republished The European

Network of Homeopathy

Researchers, An Overview of

Positive Homeopathy

Research and Surveys, ENHR

March 2007

Homeopathy on the General

Placebo Question, Annals of

Internal Medicine, March 2003,

volume 138 Issue 5 |pp.93-399

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Summary of trial findings,

1950–2009 (from the ‘Faculty of Homeopathy’)

o There are a total of 142 peer-

reviewed RCTs in 129 papers

reporting placebo controlled or

non-placebo controlled RCTs

of homeopathy: 63 (44%) had

positive findings; 11 (8%) were

© Endeavour College of Natural Health endeavour.edu.au

positive findings; 11 (8%) were

negative; 68 (48%) were non-

conclusive.

o These trials represent research

in a total of 74 different

medical conditions.

Page 7: Review of Positive and Negative Homeopathic Trialsmphm.com.my/wp-content/uploads/2017/04/Alastair Gray.pdfthings that do not make sense. Overview of Positive Trials o Carlston, M.,

Positive Homeopathic Research

o There are replicated studies

with a majority of positive

findings in 7 conditions:

• Childhood diarrhoea

(individualized treatment)

• Fibromyalgia

o Replicated trials with a majority

of statistically non-significant

or (more rarely) negative

findings have been reported in

11 areas:o Anxiety

o Childhood asthma

© Endeavour College of Natural Health endeavour.edu.au

• Influenza

• Osteoarthritis

• Seasonal allergic rhinitis

• Sinusitis

• Vertigo

o Childhood asthma

o Insect bites

o Menopausal symptoms in breast cancer

o Migraine

o Muscle soreness

o Post-operative bruising / haematoma / pain /

swelling

o Rheumatoid arthritis

o Stroke

o Upper respiratory tract infection

(prevention)

o Warts

Page 8: Review of Positive and Negative Homeopathic Trialsmphm.com.my/wp-content/uploads/2017/04/Alastair Gray.pdfthings that do not make sense. Overview of Positive Trials o Carlston, M.,

Influenza

o Papp, R., Schubuck, G., Beck E., Burkard G., Bengel J., Lengl S.,

Belon P., Occillococcinum in patient with influenza like syndrome,

British Homeopathic journal vol 87 p 69-76

o Vickers, A.J. et al, Homeopathic Oscillococcinum for preventing and

treating influenza and influenza-like syndromes., Cochrane

Database Syst Rev 2000

© Endeavour College of Natural Health endeavour.edu.au

Database Syst Rev 2000

http://www.goodmedicineconsulting.com/wp-content/uploads/2010/05/Tulips-620x380.jpg

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Respiratory System

o Treatment of seasonal allergic rhinitis

using homeopathic preparation of

common allergens in the southwest

region of the US: a randomized,

controlled clinical trial. Kim LS,

Riedlinger JE, Baldwin CM, Hilli L,

Khalsa SV, Messer SA, Waters RF ,

2005

© Endeavour College of Natural Health endeavour.edu.au

2005

Annals of Pharmacotherapy, 39:617–

624.

o Use of ultramolecular potencies of

allergen to treat asthmatic people

allergic to house dust mite: double

blind randomized controlled clinical

trial. Lewith G , Watkins AD, Hyland

ME, 2002

British Medical Journal, 324:520–523.

http://2.bp.blogspot.com/_WIT-FobyK1A/S1CRA7LIDvI/AAAAAAAAAcs/WGY5xWFpT6w/s640/Homeopathic+medicines.jpg

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Female

o Homeopathy for menopausal

symptoms in breast cancer survivors:

a preliminary randomized controlled

trial. Jacobs J, Herman P, Heron K,

Olsen S, Vaughters L ,2005

Journal of Alternative and

Complementary Medicine, 11:21–27.

o Yakir, M. et al, Effects of homeopathic

treatment in women with premenstrual

o Relton C, Weatherley-Jones E.

Homeopathy Service in a National

Health Service community

menopause clinic: audit of clinical

outcomes. Journal of the British

Menopause Society, Vol. 11, No.

2, June 2005.

© Endeavour College of Natural Health endeavour.edu.au

treatment in women with premenstrual

syndrome: a pilot study, 2001Nature

Publishing Group, www.nature.com

o Jones A. Homeopathic treatment for

premenstrual symptoms. J Fam Plann

Reprod Health Care. 2003

Jan;29(1):6-7.

http://farm4.static.flickr.com/3416/3521066469_aab64ebe6b.jpg?v=0

Page 11: Review of Positive and Negative Homeopathic Trialsmphm.com.my/wp-content/uploads/2017/04/Alastair Gray.pdfthings that do not make sense. Overview of Positive Trials o Carlston, M.,

Women

o Thompson EA, Reilly D. The

homeopathic approach to the

treatment of symptoms of

oestrogen withdrawal in breast

cancer patients. A prospective

observational study.

Homeopathy. 2003

© Endeavour College of Natural Health endeavour.edu.au

Homeopathy. 2003

Jul;92(3):131-4.

o Thomas KJ, Luff D, Strong P.

Complementary Medicine

Service in a Community Clinic

for Patients with Symptoms

Associated with the

Menopause: Outcome and

Sercive Evaluation. ScHARR,

University of Sheffield, 2001.

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Cancero Frenkel, M., et al, Cytotoxix effects of

ultra-diluted remedies on breast

cancer cells, International Journal of

Oncology 336: 395-403,2010

o Balzarini, A. at al, Efficacy of

homeopathic treatment of skin

reactions during radiotherapy for

breast cancer: a randomised, double-

blind clinical trial., PubMed Br

© Endeavour College of Natural Health endeavour.edu.au

blind clinical trial., PubMed Br

Homeopath 2 000J an; 89(l):8-12

o Kassab S., Cummings M., Berkovitz

S., van Haselen R., Fisher P.,

Homeopathic medicines for adverse

effects of cancer treatments, Cochrane

Database of Systematic Reviews

2009, Issue 2. Art. No.: CD004845.

DOI:

10.1002/14651858.CD004845.pub2

http://wwwdelivery.superstock.com/Image/1738/Thumb/1738R-18280.jpg

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© Endeavour College of Natural Health endeavour.edu.au

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© Endeavour College of Natural Health endeavour.edu.au

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Thallesemia

o Banerjee, A. et al,

Can Homeopathy

Bring Additional

Benefits to

Thalassemic Patients

© Endeavour College of Natural Health endeavour.edu.au

Thalassemic Patients

on Hydroxyurea

Therapy?

Encouraging Results

of a Preliminary

Study, 2009.

http://www.entertainmentpk.com/wp-content/uploads/2010/03/healthy-lifestyle.jpg

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Mental Health

o Chatfield, K., Is homeopathy

useful for the treatment of

people with mental health

concerns?, Homeopathy

National Knowledge Week, 11-

15 June 2007

© Endeavour College of Natural Health endeavour.edu.au

15 June 2007

http://www.healthypopulation.com/wp-content/uploads/2009/01/healthy-lifestyle.jpg

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Sleep

o Naude, D.F. et al, Chronic primary insomnia: Efficacy of

homeopathic simillimum, doi:10.1016/j.homp.2009.11.001, available

online at http://www.sciencedirect.com

© Endeavour College of Natural Health endeavour.edu.au

http://altmed.creighton.edu/IndianMedicine/homeopathic_medicine/images/AltMed2003_0013.jpg

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HIV

o Dunne, M., The effect of homeopathically prepared

growth factors, cell signal enhancers, in children with

HIV/AIDS

© Endeavour College of Natural Health endeavour.edu.au

http://www.bonjourbaby.com.au/blog/wp-content/uploads/2010/07/Homeopathic-Remedies-150x150.jpg

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ADHD

o Homeopathic treatment of children with attention deficit hyperactivity

disorder: a randomized, double blind, placebo controlled crossover trial.

Frei H, Everts R, von Ammon K, Kaufmann F, Walther D, Hsu-Schmitz SF,

Collenberg M, Fuhrer K, Hassink R, Steinlin M, Thurneysen A , 2005

European Journal of Pediatrics, 164:758–767.

© Endeavour College of Natural Health endeavour.edu.au

http://images.teamsugar.com/files/upl1/1/12981/28_2008/h_0.jpg

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Hearing Loss

o Harrison, H., A randomized comparison of homeopathic

and standard care for the treatment of glue ear in

children., Complementary Med 1999S ep;7(3:1) 32-

© Endeavour College of Natural Health endeavour.edu.au

http://dingo.care2.com/pictures/greenliving/1011/1010144.large.jpg

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Alcoholism

o Rogers, J., Homeopathy and treatment of alcohol-related

problems, Complement Ther Nurs Midwifery 1997 Feb;3

© Endeavour College of Natural Health endeavour.edu.au

http://www.coliccalm.co.uk/anit2.jpg

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Nervous Conditions

o Sedatif - Boiron

© Endeavour College of Natural Health endeavour.edu.au

http://bp2.blogger.com/_NiFZfOLBJZs/SFLAQ_R7R8I/AAAAAAAAAjE/2TNtMYh1fX4/s200/allergies.jpg

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Skin

o Rajendran, E.S., Molluscum contagiosum: a case series,

Homeopathy 2002 91, 255–259

o Keil, T. et al, Homeopathic versus conventional treatment of children

with eczema: A comparative cohort study, Complementary

Therapies in Medicine (2008) 16, 15—21

© Endeavour College of Natural Health endeavour.edu.au

http://www.collegenaturalmedicine.com/product_images/uploaded_images/image18.jpg

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Vaccination / Homeoprophelaxis

o Dr Isaac Golden

o Kata, A., A Postmodern Pandora’s Box: Anti-vaccination

misinformation on the Internet, 2009,

www.elsevier.com/locate/vaccine

© Endeavour College of Natural Health endeavour.edu.au

http://z.about.com/d/lungcancer/1/0/i/0/-/-/homeopathpic.jpg

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Chronic Fatigue

o Awdry R. Journal of Alternative and Complementary Medicine 1996;

February, March, April.

o Weatherley-Jones E, Nicholl JP, Thomas KJ, Parry GJ, McKendrik

MW, Green ST, Stanley PJ, Lynch SPJ. A randomised, controlled,

triple-blind trial of the efficacy of homeopathic treatment for chronic

fatique syndrome. Journal of Psychosomatic Research 56 (2004)

© Endeavour College of Natural Health endeavour.edu.au

fatique syndrome. Journal of Psychosomatic Research 56 (2004)

189-197.

http://i.ehow.com/images/a05/57/kf/homeopathic-callus-treatments-3.1-120X120.jpg

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Diarrhoea

o Jacobs J. Treatment of acute childhood diarrhoea with homeopathic

medicine: a randomized clinical trial in Nicaragua. Pediatrics 1994;

93: 719-725.

o Jacobs J., Jimenez M., Malthouse S., Chapman E., Crothers D.,

Masuk M., Jonas W.B., Acute Childhood Diarrhoea- A Replication.,

Journal of Alternative and Complementary Medicine, 6, 2000, 131-

139.

© Endeavour College of Natural Health endeavour.edu.au

139.

http://www.post420mag.com/wp-content/uploads/2010/03/homeopathy1.s600x600.jpg

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Glue Ear and Throats

o Influence of potassium dichromate on

tracheal secretions in critically ill

patients. Frass M, Dielacher C,

Linkesch M, Endler C, Muchitsch I,

Schuster E, Kaye A, 2005

Chest, 127:936–941.

o Friese K-H, Kruse S, Ludtke R,

© Endeavour College of Natural Health endeavour.edu.au

o Friese K-H, Kruse S, Ludtke R,

Moeller H "Homeopathic treatment of

otitis media in children: comparisons

with conventional therapy". Int J Clin

Pharmacol Ther. 1997; 35: 296-301.

o Homeopathic treatment of acute otitis

media in children: a preliminary

randomized placebo-controlled trial.

Jacobs J, Springer DA, Crothers D,

2001

Pediatric Infectious Disease Journal,

20:177–183.

http://drnovickhomeopath.com/wp-content/uploads/2009/10/row-of-bach-bottles-new-copy.jpg

Page 28: Review of Positive and Negative Homeopathic Trialsmphm.com.my/wp-content/uploads/2017/04/Alastair Gray.pdfthings that do not make sense. Overview of Positive Trials o Carlston, M.,

Sinusitis

o Adler M. Efficacy, safety of a fixed-combination

homeopathic therapy for sinusitis. Adv Ther 1999; 16:

103–111

© Endeavour College of Natural Health endeavour.edu.au

http://www.globalholistichealthcare.com/images/swine-flu-virus_jps.jpg

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Muscular-Skeletal / Fibrositis

o Effects of the homoeopathic remedy Arnica D30 on marathon

runners: a randomized, double-blind study during the 1995 Oslo

Marathon. Tveiten D, Bruseth S, Borchgrevink CF, Norseth J,1998

Complementary Therapies in Medicine, 6:71–74.

o Fisher P. An experimental double-blind clinical trial in homoeopathy.

British Homeopathic Journal 1986; 75: 142-147.

© Endeavour College of Natural Health endeavour.edu.au

British Homeopathic Journal 1986; 75: 142-147.

http://www.opposingviews.com/attachments/0010/0996/nn20101005i1a.jpg?1288082509

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Fibromyalgia

• Bell IR, Lewis II DA, Brooks

AJ, Schwartz GE, Lewis

SE, Walsh BT, Baldwin

CM. Improved clinical

status in fibromyalgia

patients treated with

© Endeavour College of Natural Health endeavour.edu.au

patients treated with

individualized homeopathic

remedies versus placebo

http://rheumatology.oupjour

nals.org/cgi/reprint/keh111

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Surgery

o Seeley BM, Denton AB, Ahn MS, Maas CS. Effect of Homeopathic Arnica

montana on Bruising in Face-lifts. Results of a Randomized, Double-blind,

Placebo-Controlled Clinical Trial. Arch Facial Plast Surg/Vol 8, Jan/Feb

2006.

© Endeavour College of Natural Health endeavour.edu.au

http://www.abc.net.au/catalyst/stories/img/Homeopathy_m577062.jpg

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Dengue

© Endeavour College of Natural Health endeavour.edu.au

http://www.sherwoodtowne.com/pb/images/img1247348893b0932957.jpg

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© Endeavour College of Natural Health endeavour.edu.au

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Cost

o Thomas K.J., Nicholt J.P.,

Coleman P., Use and expenditure

on complementary medicine in

England: a population based

survey., Pubmed: Complement

Ther Med. 2001 Mar;9(1):2-11.

o Witt C, Keil T, Selim D, Roll S,

Vance W, Wegscheider K, Willich

o Fisher, P., It's cheaper

and has no nasty side-

effects, The Daily Mail,

(UK), 24 May 2006.

© Endeavour College of Natural Health endeavour.edu.au

Vance W, Wegscheider K, Willich

SN. Outcome and costs of

homeopathicand conventional

treatment strategies: A

comparative cohort study in

patients with chronic disorders.

Complementary Therapies in

Medicine (2005) 13, 79-86.

http://www2.worthingtonlibraries.org/teen/blog/Image/To_study_by_alma_lunar_1.jpg

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Cost

o Jain A. Does homeopathy reduce the

cost of conventional drug prescribing?

A study of comparative prescribing

costs in General Practice.

Homeopathy (2003) 92, 71-76.

o Schafer T, Riehle A, Wichmann HE,

© Endeavour College of Natural Health endeavour.edu.au

o Schafer T, Riehle A, Wichmann HE,

RingJ. Alternative medicine in

allergies—prevalence, patterns of use,

and costs. Allergy 2002; 57: 694–700.

o Swayne J. The cost effectiveness of

homoeopathy. A pilot study, proposals

for future research. Br Homoeopath J

1992; 81: 148–150

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Patient Satisfaction

o Spence DS, Thompson EA,

Barron SJ. Homeopathic

Treatment for Chronic Disease: A

6-Year, University-Hospital

Outpatient Observational Study.

The Journal of Alternative and

Complementary Medicine. Volume

o Steinsbekk, A. Patients' assessments

of the effectiveness of homeopathic

care in Norway: A prospective

observational multi-centre outcome

study. Homeopathy, Volume 94, Issue

1, January 2005, Pages 10-16.

© Endeavour College of Natural Health endeavour.edu.au

Complementary Medicine. Volume

11, Number 5, 2005, pp. 793-798.

o Witt CM, Luedtke R, Baur R,

Willich SN. Homeopathic Medical

Practice: Long-term results of a

Cohort Study with 3981 Patients.

BMC Public Health 2005, 5:115.

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Patient Outcome and Satisfaction

o F. Attena et al. Homeopathy in

Primary Care: self reported change in

health status. Complementary

therapies in Medicine Vol 8 No 1.

March 2000.

o Sevar, R. Audit of outcome in 829

consecutive patients treated with

homeopathic medicine. British

© Endeavour College of Natural Health endeavour.edu.au

homeopathic medicine. British

Homeopathic Journal Vol 89 No.4. Oct

2000.

o Güthlin C, Lange O and Walach H.

Measuring the effects of acupuncture

and homoeopathy in general practice:

An uncontrolled prospective

documentation approach. BMC Public

Health 2004, 4:6.

http://libweb.uoregon.edu/pix/news/newsletters/scuaclassroomsmall.jpg

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The Negative

© Endeavour College of Natural Health endeavour.edu.au

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Opposition to Homeopathy Comes From …

o Sceptics

• Wikipedia

o Organisations

• Sense about Science

• http://www.senseaboutscie

© Endeavour College of Natural Health endeavour.edu.au

• http://www.senseaboutscie

nce

• org.uk/pdf/SenseAboutHo

meopathy.pdf

o Media

o Young doctorshttp://www.news.cornell.edu/stories/March07/studySpace.jpg

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Clinical Researchers

o Are those trials that are positive well conducted?

© Endeavour College of Natural Health endeavour.edu.au

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Homeopathic Prophylaxis of Headaches

and Migraine? A Systematic Review

Edzard Ernst

o The aim of this systematic review was to evaluate the clinical trials, testing the

efficacy of homeopathy for these indications. Independent computerized literature

searches were carried out in 4 databases. Only randomized, placebo-controlled trials

© Endeavour College of Natural Health endeavour.edu.au

searches were carried out in 4 databases. Only randomized, placebo-controlled trials

were included.

o Four such studies were found. Their methodological quality was variable but,

on average, satisfactory. One study suggested that homeopathic remedies

were effective. The other, methodologically stronger trials did not support this

notion. It is concluded that the trial data available to date do not suggest that

homeopathy is effective in the prophylaxis of migraine or headache beyond a

placebo effect. J Pain Symptom Manage 1999;18:353–357.

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Efficacy of Homeopathic Arnica A

Systematic Review of Placebo-Controlled

Clinical Trials. E. Ernst, M. H. Pittler

o Background The efficacy of homeopathic remedies has remained controversial. The

homeopathic remedy most frequently studied in placebo-controlled clinical trials is

Arnica montana. Objective. To systematically review the clinical efficacy of

homeopathic Arnica. Materials and Methods Computerized literature searches were

performed to retrieve all placebo-controlled studies on the subject. The following

databases were searched: MEDLINE, EMBASE, CISCOM, and the Cochrane Library.

© Endeavour College of Natural Health endeavour.edu.au

databases were searched: MEDLINE, EMBASE, CISCOM, and the Cochrane Library.

Data were extracted in a predefined, standardized fashion independently by both

authors. There were no restrictions on the language of publications.

o Results Eight trials fulfilled all inclusion criteria. Most related to conditions

associated with tissue trauma. Most of these studies were burdened with

severe methodological flaws. On balance, they do not suggest that

homeopathic arnica is more efficacious than placebo. Conclusion The claim

that homeopathic arnica is efficacious beyond a placebo effect is not supported

by rigorous clinical trials.

http://a2zhomeopathy.com/images/1-nhs_header_photo_books.jpg

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o Homeopathy remains one of the most controversial subjects in therapeutics.

This article is an attempt to clarify its effectiveness based on recent

systematic reviews. Electronic databases were searched for systematic

reviews/meta-analysis on the subject. Seventeen articles fulfilled the

inclusion/exclusion criteria. Six of them related to re-analyses of one

landmark meta-analysis. Collectively they implied that the overall positive

result of this meta-analysis is not supported by a critical analysis of the data.

Eleven independent systematic reviews were located. Collectively they

Abstract

© Endeavour College of Natural Health endeavour.edu.au

Eleven independent systematic reviews were located. Collectively they

failed to provide strong evidence in favour of homeopathy. In particular,

there was no condition which responds convincingly better to

homeopathic treatment than to placebo or other control interventions.

Similarly, there was no homeopathic remedy that was demonstrated to

yield clinical effects that are convincingly different from placebo. It is

concluded that the best clinical evidence for homeopathy available to

date does not warrant positive recommendations for its use in clinical

practice.

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Shang

o Shang A., Huwiler-Müntener K., Nartey L., Jüni P., Dörig S., Sterne

J.A., Pewsner D., Egger M., Are the clinical effects of homeopathy

placebo effects? - A full critique of the article, PubMed: (Lancet

2005;366 (9487):726-733)

© Endeavour College of Natural Health endeavour.edu.au

http://i.dailymail.co.uk/i/pix/2008/12/04/article-1091856-006424FC00000578-930_233x315.jpg

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Most Systematic Reviews are Negative

© Endeavour College of Natural Health endeavour.edu.au

http://www.homeorizon.com/images/member-files/homeopathic_pills.jpg

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Cochrane Systematic Reviews of

Homeopathy

o Induction of labour – insufficient evidence for recommending use of homeopathy. Caulophyllum trial did not reflect use in homeopathy practice therefore should not be relied upon

© Endeavour College of Natural Health endeavour.edu.au

o Dementia – no adequate studies to base review on, extent of homeopathic prescribing for dementia difficult to establish and therefore difficult to decide if this is a valuable area for research or not.

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Negative SR’s

o Chronic asthma – lack of research for reliable assessment of homeopathy use, needs observational studies on homeopathy prescribing and patients responds – is if response to a ‘package of care’ or homeopathic intervention alone

© Endeavour College of Natural Health endeavour.edu.au

o Oscillococcinum for ‘flu – some promising data but not strong in relation to recommendation for first-line treatment of ‘flu and ‘flu like symptoms – further research needs larger sample sizes and to look at prevention of symptoms role

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© Endeavour College of Natural Health endeavour.edu.au

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Well designed trials have come up

with negative results

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The Problems of Homeopathy

o Holistic perspective

o Individuality

o Response time

o Aggravations

Dose

© Endeavour College of Natural Health endeavour.edu.au

o Dose

o Methodology

o Inclusion criteria

o These are a challenge

to design a trial

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The Lines Are Drawn

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Problems with Systematic Reviews for

Homeopathy

• Systematic reviews focus upon benefits for particular disease states

• They are reductionist by nature and cannot embrace a holistic approach

© Endeavour College of Natural Health endeavour.edu.au

holistic approach

• There are relatively few trials in homeopathy for any one condition

• Trials that exist vary greatly in quality and are normally underpowered (not enough participants because they do not have enough funding)

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Problems with Cohort Studies in

Homeopathy

© Endeavour College of Natural Health endeavour.edu.au

http://assets2.parliament.uk/iv/main-large/id_5291.jpg

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© Endeavour College of Natural Health endeavour.edu.au

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Problems with the RCT in Homeopathy

o The Randomized Control Trial (RCT) is considered the

highest level of ‘evidence’ due to the rigorous scientific

methods that are required and its ability to test

hypothesis (Akobeng, 2005, p. 840). In this process

there is a ‘random’ assignment of participants to prevent

© Endeavour College of Natural Health endeavour.edu.au

there is a ‘random’ assignment of participants to prevent

bias. Areas to consider in evaluation of RCT are

(Akobeng, 2005, p. 841):

http://www.gaia-health.com/images/000011-titleimage.png

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The Response from Homeopathy:

o This is Not Real World?

© Endeavour College of Natural Health endeavour.edu.au

http://www.cyprusspirit.com/n09homeopathy.jpg

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What do we have in Homeopathy?

o Committed researchers dedicated to creating a small

but solid body of evidence

o And….

© Endeavour College of Natural Health endeavour.edu.au

http://www.wellintent.com/images/hands_around_plant.jpg

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Thousands of Positive Cases over 200

Years

o Inductive reasoning

o Empiricism

© Endeavour College of Natural Health endeavour.edu.au

http://www.alternativehealth-research.com/images/steps.jpg

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Not in an evidence based world

o Positivism

o Deductive Reasoning

o Evidence

o Hierarchy

© Endeavour College of Natural Health endeavour.edu.au

http://www.visvitaliseducation.com/visvitalis/Hands_Holding_Plant.jpg

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‘There is No Research’

o Wrong

There is research in

© Endeavour College of Natural Health endeavour.edu.au

o There is research in

these areas, conditions

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‘Its placebo’

o Its implausible

therefore it doesn’t

work

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Its just a placebo effect?

o Homeopaths are caring people

o We spend a lot of time with our patients; we listen and we develop

© Endeavour College of Natural Health endeavour.edu.au

patients; we listen and we develop good rapport

o We facilitate and actively encourage a process of self-understanding in our patients

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The sceptic’s observation:

o ‘If it is a placebo effect at

work in homeopathy, all

of the pseudoscientific

trappings of similia

similibus curantur and the

© Endeavour College of Natural Health endeavour.edu.au

similibus curantur and the

law of infinitesimals

merely serve as props to

deceive people into

believing that sugar pills

are medicine.’(Robert L.

Park, Alternative

Medicine and the Laws of

Physics)

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Mastitis

o Relton C., O'Cathain A., Thomas K.J., Homeopathy -

Untangling the debate, PubMed: Homeopathy. 2008

Jul;97(3):152-5

o Varshney

© Endeavour College of Natural Health endeavour.edu.au

o Varshney

o Day

o Sutherland

http://www.familydoctormag.com/blog/wp-content/uploads/2008/09/meds.jpg\

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Plant Trials

o Betti, Lazzarato, Trebbi, Brizzi, Calzoni, & Nani, 2003

© Endeavour College of Natural Health endeavour.edu.au

http://mystikegg.com/wp-content/uploads/2008/01/accupuncture-meridians.jpg

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Plant Trials

o Hamman, Koning, & Lok, 2003

© Endeavour College of Natural Health endeavour.edu.au

http://4.bp.blogspot.com/_R45AOe3Yiwo/SgckyAFavmI/AAAAAAAAAQk/TrigDn3z3KM/s4

00/placebo..jpg

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Placebo Studies

o Spinney, L., Purveyors of mystery, Placebo Purveyors of

mystery - 16 December 2006 Volume 192, Issue 2582 -

New Scientist

o Weatherley-Jones W., Relton, C., Researching

Homeopathic Treatment: Can the Placebo Model Really

© Endeavour College of Natural Health endeavour.edu.au

Homeopathic Treatment: Can the Placebo Model Really

be an Appropriate Test of Homeopathy?, Homeopathy,

2003,(88) pp. 24-25.

http://www.popsci.com/files/imagecache/article_image_large/articles/placebo%20spine%20cut.jpg

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Witt, Linde and the Study of

Placebo

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The Future

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Conclusions

o Clinical homeopathic research is clearly in its infancy with most

studies using poor sampling and measurement techniques, few

subjects, single sites and no replication. Many of these problems

are correctable even within a "holistic" paradigm given sufficient

research expertise, support and methods.

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o Dantas F, Rampes H. Do homeopathic remedies provoke adverse effects? A systematic review. Br. Homeopathic

Journal 2000 (Supl 1); 89:pp35-38

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o Hoffmann et all (2010) Evidence Based Medicine Across the Health Professions Churchill Livingstone

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o Carlston, M. 2003, Classical Homeopathy, Churchill Livingston, New York

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o UK Parliamentary Committee Science and Technology Committee. "Evidence Check 2: Homeopathy”.

o Kaptchuk, TJ; Friedlander, E; Kelley, JM; Sanchez, MN; Kokkotou, E; et al (2010), "Placebos without deception: a

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o David H. Newman (2008). Hippocrates' Shadow. Scribner. pp. 134–59. ISBN 1-4165-5153-0.^ a b c d Hróbjartsson

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A, Gøtzsche PC (2001). "Is the placebo powerless? An analysis of clinical trials comparing placebo with no

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References

o MONTAGNIER, L., A¨ISSA, J., FERRIS, S., MONTAGNIER, J.-L., & LAVALL, C. (2009). Electromagnetic Signals Are Produced by

Aqueous Nanostructures Derived from Bacterial DNA Sequences.

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o Rey, L. (2007). Can low-temperature thermoluminescence cast light

on the nature of ultra-high dilutions? Homeopathy, 96, 170-174.

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on the nature of ultra-high dilutions? Homeopathy, 96, 170-174.

o Schulte, J. (1999). Effects of potentization in aqueous solutions.

British Homeopathic Journal, 88, 155-160.

o Tschulakow, A., Yan, Y., & Klimek, W. (2005). A new approach to the

memory of water. Homeopathy, 94, 241-247.

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References

o Witt C (2010) et al the

Future of Homeopathic

Research Verlag

Germany

o Kane, M (2004) Research

o Lewith, G; Walach, H;

Jonas, W (2002) ‘Clinical

Research in

Complementary

Therapies’ Churchill

© Endeavour College of Natural Health endeavour.edu.au

o Kane, M (2004) Research

Made Easy in

Complementary and

Alternative Medicine

Churchill Livingstone:

London

Therapies’ Churchill

Livingstone: London

o Emmans-Dean, M (2004)

The Trials of Homeopathy

Verlag Germany

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Some websites with information about

research in homeopathy

• National Centre for Homeopathy

http://www.homeopathic.org/resea

rch.htm

• Homeopathic Educational

Services

http://www.homeopathic.com/articl

es/research/index.php

o Homeopathy Research Institute,

http://www.homeoinst.org/databas

e/result?keys=positive

o Faculty of Homeopathy,

http://www.facultyofhomeopathy.or

g/research/rcts_in_homeopathy/in

dex.html

© Endeavour College of Natural Health endeavour.edu.au

es/research/index.php

• Homeopathy http://www.harcourt-

international.com/journals/homp

• Boiron

http://www.boiron.com/en/htm/04-

politique/clinique.htm

dex.html

o The Society of Homeopaths,

http://www.homeopathy-

soh.org/whats-

new/research/resorg.aspx