11 Systematic Reviews and 11 Meta-Analysis in Evidence of Homeopathy

· homeopathy
Authors
INTRODUCTION
Bias: Bias is a systematic error i.e. the difference between study findings/outcomes and the truth.Publication Bias: The tendency for studies with a positive result to be published more readily than those which are negative or inconclusive.

Meta-Analysis of RCT: It is a statistical method of combining results from multiple randomised controlled trials for different indications in the form of a weighted average (some studies carries more weight than others) to determine overall trend or significance as an output. It helps in reducing information overload, find publication bias, if any and may explain heterogeneity between the results of individual studies.

Systematic Review: It is a synthesis of the results of several studies (including conflicting studies) so as to assess the strength of the evidence. A review is termed systematic if it is based on clearly formulated peer-reviewed protocols (in advance) such as research question, clear inclusion/exclusion criterion, explicit search strategy, critical appraisal, etc and employs the same level of scientific rigour as should be used to produce that research evidence in the first place. A systematic review is as good as the quality of the studies included in the review. A systematic review can be independently replicated. The first systematic review in evidence of homeopathy was published in 2000.

Systematic reviews often, but not always, use statistical techniques such as meta-analysis to combine results of the eligible studies. The purpose of both meta-analysis and systematic review is to obtain a better understanding of how the treatment works.

RESEARCH STUDIES

A Compendium of 22 research articles (10 full-text PDF) on 11 systematic reviews and 11 meta-analysis in evidence of homeopathy. [click to tweet]

Inclusion Criterion: Human and in-vitro studies with statistically significant results in peer-reviewed articles in journals upto the year 2013

Exclusion Criterion: plant and animal studies, non-journal studies, radionically prepared or different potencies of same medicine mixed together

META-ANALYSIS

The first meta-analysis (on typhoid inoculation) was published in the British Medical Journal in 1904. The first meta-analysis of medical treatment was published in 1955. The first meta-analysis in evidence of homeopathy was published in 1991.

Upto the end of the year 2013, there have been 11 meta-analysis (1 on in vitro study, 1 on combination remedy) published in 13 medical journals.

11 meta-analysis are classified into 3 categories: Comprehensive/global/broad spectrum of medical conditions (5), specific medical condition (5) and super-Avogadro dilution effect (1).

META-ANALYSIS (COMPREHENSIVE)

1. British Medical Journal

Clinical Trials of Homoeopathy (1991) FULL TEXT

81 (77%) out of 105 RCT (1943-1990) shows a statistically significant result for homeopathy and 15 out of 22 best quality studies are also statistically significant. Out of 81, 5 out of 5 of the clinical trials for hay fever showed a positive result and 8 out of 10 trials looking at mental or emotional problems showed a beneficial effect, while 6 out of 7 trials for infection showed that homeopathy could effectively relieve the problem.

“Based on this evidence we would be ready to accept that homoeopathy can be efficacious if only the mechanism of action were more plausible” and “the evidence presented in this review would probably be sufficient for establishing homoeopathy as a regular treatment for certain indications……..a conventional method would have been acknowledged with this amount of evidence”, the results are mostly favourable for homeopathy regarding the quality of trials.”

2. The Lancet

Are clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials Linde et.al. (1997) FULL TEXT

AMSTAR score=9/11. 74 out of 89 RCT (1966-1995) showed homeopathy statistically significantly superior [2.45 times more effective and positive at 95% confidence interval (CI)] to placebo. After correction for publication bias, the odds ratio reduces to 1.78, still statistically significant. 26 out of 89 studies were of high quality for which the odds ratio reduces further to 1.66, still significant. In 1999, the authors reassessed the studies and found that 10 trials with the highest Jaded score of 5 are still significant.

The main conclusion was that the results “were not compatible with the hypothesis that the effects of homoeopathy are completely due to placebo.”

3. The Journal of Alternative and Complementary Medicine

Randomized controlled trials of individualized homeopathy: a state-of-the-art (1998)

AMSTAR score =8/11. Out of 32 RCT for 19 clinical conditions, the overall odds ratio for high quality 19 trials =1.62 (statistically significant) at 95% CI which reduces to 1.12 (not statistically significant) for 6 best quality trials at 95% CI.

4. European Journal of Clinical Pharmacology

Evidence of clinical efficacy of homeopathy (2000)

AMSTAR score =10/11, 11 (65%) out of 17 comparisons in 16 RCT (1967-1998) for 15 clinical condition shows statistically significant results, p= 0.000036. For 16 double-blind RCT, p=0.000068. For 9 randomised double-blind studies, p=0.0084. For 5 high-quality double-blind RCT, p=0.082. Significant effect of homeopathy (p=0.048) in the duration of diarrhoea. Significant effect of homeopathy over placebo in influenza (p=0.0257).

5. Homeopathy

The 2005 meta-analysis of homeopathy: the importance of post-publication data (2008) FULL TEXT

META-ANALYSIS ON SPECIFIC MEDICAL CONDITION

6. Journal of Clinical Gastroenterology

Homeopathy for postoperative ileus?: meta analysis (1997) Barnes, E. Ernst

AMSTAR score=6/11.  6 trials, 776 patients, medicines: Opium, Arnica montana, Raphanus sativus, China, Pyrogenum, 4 out of 6 trials are of the best quality. Two of the four studies that also measured time to first faeces reported a positive effect for homeopathy. A meta-analysis of all six included studies revealed a statistically significant effect in favour of homeopathy for time to first flatus (weighted mean difference (WMD) -7.4; 95% CI -4.0 to -10.8; p<0.05). This effect remained even with the exclusion of the two low-quality studies (WMD -6.11; 95% CI -2.31 to -9.91; p<0.005). A significant effect in favour of homeopathy was also found for time to first flatus when a homeopathic remedy of less than 12C potency was used (4 studies; WMD -6.6; 95% CI -2.6 to -10.5; p<0.05). Conclusion: “there is some evidence to support the administration of a homeopathic remedy immediately after surgery to reduce the duration of ileus”

7. Wiener Medizinische Wochenschrift

A meta-analysis of Homeopathic treatment of Pollinosis with Galphimia glauca (1997)

Galpimia Glauca in 2c, 4c, 4x, 6x, LM4. n=1038.  The odds ratios of all of the four individual studies favoured homeopathy, and in two of the four studies the result was statistically significant. After the results were pooled, the odds ratio of 1.87 suggested that Galphimia glauca is significantly more effective than placebo.

8. British Medical Journal

Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series (2000) FULL TEXT

4 double-blind randomized placebo-controlled trial (DBRPCT) (2 on hayfever, 1 on asthma and 1 on perennial rhinitis) with n=253, p=0.0007, mixed pollen 30c for hayfever. Allergan 30c Vs Placebo. n=51, Mean nasal inspriatory peak airflow improved by 21 % in homoepathic patients and 2 % in placebo patients, Jadad score=5, “It may be time to confront the conclusion that homeopathy and placebo differ..”

9. Paediatric Infectious Disease Journal

Homeopathy for childhood diarrhea  (2003) FULL TEXT

n=242, age=6 months to 5 years, t=5 days, p=0.008, A meta-analysis of three studies showing individualized homeopathy reduced the duration of the disease by a quarter (0.66 days). Diarrhoea ceased in those taking homeopathic medicines after 3.3 days and after 4.1 days in those using placebo.

10. Arzneimittel-Forschung (German)/ Medicines Research

Treatment of Vertigo With a Homeopathic Complex Remedy Compared With Usual Treatments (2005) combination remedy VertigoHeel

META-ANALYSIS ON SUPER-AVOGADRO DILUTIONS

11. Human and Experiment Toxicology

Critical Review and Meta-analysis of serial agitated dilutions in experimental toxicology (1994) 80% homeopathic medicines shows efficacy

SYSTEMATIC REVIEWS

Upto the end of the year 2013, there have been 11 systematic reviews (out of approximately 25) in favour of homeopathy. 11 systematic reviews are classified into 4 categories: Comprehensive (5), specific medical conditions (4), super-Avogadro dilutions (1) and placebo effect (1)

SYSTEMATIC REVIEWS (COMPREHENSIVE)

1. Rheumatic Diseases Clinics of North America

Homeopathy and Rheumatic Disease (2000) 6 controlled trials (3 in Rheumatoid Arthritis with n=226, 1 osteoarthritis, 1 fibromyalgia) with n=392, odds ratio= 2.19 at 95% CI, for high-quality trials OR=2.11, still significant (p=0.002)

2. Forschende Komplementarmedizin (German) meaning ‘Research in Complementary Medicine’

Effectiveness, Safety and Cost-Effectiveness of Homeopathy in General Practice (2006) FULL TEXT

3. Evidence based Complementary and Alternative Medicine

Immunolgy and Homeopathy-4 PART-1 (2006) FULL TEXT

Immunolgy and Homeopathy-4 PART-2 (2006) FULL TEXT

4. The Journal of Clinical Psychiatry

Homeopathic Treatments in Psychiatry (2011) Efficacy of homeopathy was found for fibromyalgia and chronic fatigue syndrome in RPCT. A funnel plot in 13 studies suggest no publication bias

SYSTEMATIC REVIEWS ON SPECIFIC MEDICAL CONDITION

5. British Homeopathic Journal

Homeopathic remedies for the treatment of osteoarthritis: a systematic review (2001) Long and E. Ernst.

4 RCT with n=506, Zeel superior to hyaluronic acid, combination of Rhus Tox, Causticum and Lac Vac superior to paracetamol, AMSTAR score=6/10, homeopathy found to be “at least as effective” as a conventional NSAID gel, “positive trend towards the effectiveness of combination homeopathic preparations”

6. Focus on Alternative and Complementary Therapies

Homeopathic Galphimia glauca for hay fever (2011) Edzard Ernst. 3 out of 4 RPCT in favour of homeopathy over placebo

7. Cochrane Database of Systematic Review

Homeopathic medicines for adverse effects of cancer treatments (2009)

8 RCT (7 placebo-controlled and 1 against active intervention) with n=664, 2 trials in support of homeopathy

Homeopathic medicines for the prevention or treatment of adverse effects of chemotherapy, radiotherapy, and menopausal symptoms caused by hormonal therapies or oestrogen withdrawal.

Compared with trolamine, calendula reduced the incidence of acute dermatitis of grade two or above in women undergoing radiotherapy for breast cancer in one clinical trial involving 254 participants.

Based on a single trial involving 32 participants, Traumeel S appears to show promise in the treatment of chemotherapy-induced stomatitis.

Homeopathy for Treatment of Irritable Bowel Syndrome (2013)

A meta-analysis of two small studies (129 participants with constipation-predominant IBS) found a statistically significant difference in global improvement between the homeopathic remedy asafoetida and placebo at a short-term follow-up of two weeks. Seventy-three per cent of patients in the homeopathy group improved compared to 45% of placebo patients (Relative Risk 1.61, 95% CI 1.18 to 2.18).

SYSTEMATIC REVIEWS ON SUPER-AVOGADRO DILUTIONS

8. Complementary Therapies in MedicineThe in vitro evidence for an effect of high homeopathic potencies—A systematic review (2007) FULL TEXT73% of 67 in-vitro experiments (1/3 of them replicated) published in 75 publications showed specific effects with high dilutions including 68% of high-quality experiments (SAPEH score>=6). Nearly 3/4 of them found a high potency effect. Nearly 3/4 of all replications were positive.

SYSTEMATIC REVIEWS ON PLACEBO EFFECT

9. Homeopathy

Placebo effect sizes in homeopathic compared to conventional drugs – a systematic review of
randomised controlled trials (2010) FULL-TEXT Placebo effect sizes in placebo-controlled RCT of individualised homeopathy are same as that of conventional trials

CONCLUSION

Download 5 meta-analysis and 5 systematic reviews in PDF from Google Drive.

References: Scientific research in Homeopathy

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Last Modified: This webpage was last updated on 24 June 2020.

4 Comments

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  1. Dr. Nancy Malik

    Upto the end of the year 2007, conventional medicine has 447 out of 1016 systematic reviews as positive (44%), 49% are inconclusive and 96% recommend further research.
    Ref: El Dib, R.P., Atallah, A. N. & Andriolo, R. B. Mapping the Cochrane evidence for decision making in health care. Journal of Evaluation in Clinical Practice. 13, pp.689–692 (2007).


    https://photos.google.com/share/AF1QipPfAgSPr1DnZjXxRP4uNihIUgDLz-OER7EsZG2uWrmHs26m_UO5ROtfh4VitMcPbg

    Like

  2. debbybruck

    Very nice compendium of clinical trials that were published in medical journals. Of course, many thousands more trials were conducted, but not published to add to this database. Your article was unbiased and clear, just posting the reports without commentary, allowing readers to come to their own conclusions. Thank you, Nancy.

    Like

  3. Jayney

    Thank you Nancy – this is most helpful.

    Like

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