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Homeopathy versus Standard Treatments

Clinical bottom line: There is no evidence to demonstrate the relative efficacy of various homeopathic remedies in comparison to standard drug treatment. All existing comparative trials are of poor methodological quality.


Classic homeopathy may be described as individualised homeopathic remedies prescribed on the basis of ‘like cures like'. The choice of remedy is determined by the individual and subjective symptoms of each patient.

Systematic review

Ernst E. Classical Homeopathy Versus Conventional Treatments: A Systematic Review. Perfusion 1999;12:13-15

Date review completed: 1999

Number of trials included: 6

Number of patients: A total of 508 in active and control groups, individual group sizes were not given

Control group: oral salicylates, salazopyrine plus aspirin, dicyclomine hydrochloride plus dietary measures, chloroquine, antibiotics

Main outcomes: Outcomes were not explicitly defined in the review but described as subjetive improvement, clinical response, symptom score and pain

Inclusion criteria were controlled trials comparing individualised homeopathic remedies with conventional drug therapies. There was no restriction to language of publication.

The author conducted an extensive search of the literature including the main databases and reference lists of retrieved reports, and experts in the field were contacted. Overall six controlled trials were included in the review and a brief descriptive summary of each trial was given by the author.

Findings

Without exception, all of the trials were of poor quality with serious methodological flaws. These included lack of randomisation, blinding and statistical testing, small group sizes and high drop-out rates.

There were three RCTs, two were double-blind. One trial on 38 patients showed salazopyrine plus aspirin was more effective than homeopathy for proctocolitis based on only 12 patients completing the 12 month treatment period. No data or statistical test results were presented in the review. The other trial on 129 patients failed to demonstrate a difference between chloroquinine and homeopathy for allieviating the acute clinical response of malaria. The outcomes were not defined by the reviewer, data or statistical test results were not presented in the review, and trial sensitivity was not shown.

The third RCT of 43 patients with irritable bowel syndrome concluded that there was no difference between homeopathy and dicyclomine plus dietary measures for clinical outcomes (unspecified by the reviewer). The trial was not blind, outcomes were not defined (how and when they were measured), the reviewer did not state what statistical tests were done and if they were appropriate, The caveat about trial sensitivity applies as above.

Three trials were neither randomised nor blind, their findings therefore, are spurious due to selection and observer bias. Two of these three trials reported positive results for homeopathy groups.

These trials are so methodologically flawed that they make no contribution to determining the relative effectiveness of homeopathy.

Adverse effects were not reported in the review

Further reading


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