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.
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
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.
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).
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
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).
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
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
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
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’
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
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.
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
SYSTEMATIC REVIEWS ON PLACEBO EFFECT
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
References: Scientific research in Homeopathy
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Last Modified: This webpage was last updated on 24 June 2020.