Society of Homeopaths Research Ebulletin

Society of Homeopaths Research Ebulletin

Research

Homeopathy is a system of medicine that involves treating the individual with highly diluted substances with the aim of supporting the body’s natural system of healing. Based on their specific symptoms, a homeopath will match the most appropriate medicine to each patient. Homeopathic medicines (often called remedies) are prepared by specialist pharmacies using a careful process of dilution and succussion (a specific form of vigorous shaking).As yet, science has not been able to explain the mechanism of action of these ultra- high dilutions in the body, but laboratory experiments are increasingly showing that homeopathically prepared substances can cause biological effects. There is also a growing body of research evidence suggesting that homeopathic medicines have clinical effects too. However, the scientific debate over the evidence base for and against homeopathy continues.

Clinical Trials

Clinical trials are experiments carried out on patients to compare the effects of treatments under highly controlled conditions. One type of clinical trial – the randomised controlled trial (RCT) – is considered by many scientists to be the ‘gold standard’ of research methods for determining whether medical treatments are effective, especially if the control group for comparison is a placebo and both patients and practitioners are blinded as to whether the treatment given is placebo or the test treatment. These are known as double blind – randomised controlled trials (DB-RCTs).RCTs have been used to investigate various different aspects of homeopathy, such as how homeopathic medicines compare with placebo and how effective homeopathic treatment is for specific conditions.

“Up to the end of 2011, there have been 164 peer-reviewed papers reporting randomised controlled trials (RCTs) in homeopathy. This represents research in 89 different medical conditions. Of those 164 RCT papers, 71 (43%) were positive, 9 (6%) negative and 80 (49%) non-conclusive1”.

The fact that 80 trials were inconclusive highlights the need for changes in the way homeopathy research is conducted in future to ensure that meaningful results are generated from clinical trials. Three key factors for improving the clinical trial evidence base for homeopathy are2:

  • the need for larger scale trials with larger sample sizes (commonly prevented by a lack of funding)
  • the use of research methods that are better suited to the task of testing homeopathy as a complex individualised therapy (such as pragmatic trials which allow treatment by a homeopath as experienced in real world practice, to be compared)
  • assess the value of homeopathy across a wider range of illnesses with repetition in each condition.

Given that homeopathy is a holistic therapy (treating the person as a whole rather than treating specific diseases) it can appear contradictory to have research trials testing homeopathic treatment of specific medical conditions. There are three main reasons why researchers are performing clinical trials that assess how effective homeopathic treatment is for a specific disease, working through this apparent clash of philosophies:

  1. Patients considering seeing a homeopath often ask whether homeopathy can help with the health problem that is bothering them most (their chief complaint)
  2. When another medical professional refers a patient to a homeopath they may want to know what track record the therapy has in treating that specific disease
  3. The NHS provides the majority of medical services according to disease categories. So for homeopathy to be included in the range of services offered by specific departments, research needs to demonstrate that homeopathic treatment is effective in treating specific conditions.

Research in homeopathy is a wide field and clinical trials are just one of many different avenues being pursued by researchers world-wide to build the evidence base for homeopathy, particularly the evidence base for homeopathy in practice.

The British Homeopathic Association has prepared a comprehensive list of positive trials investigating specific medical conditions that can be accessed here http://www.britishhomeopathic.org/conditions-with-overall-positive-evidence-for-homeopathy/.

Homeopathy in practice

There are many different types of research evidence used to assess medical treatments. These research approaches vary in a number of key properties – size of the study, whether they are performed under ideal conditions or real-world conditions, whether they test a treatment for a specific condition or for safety, whether the patients are blinded to the treatment received, etcetera.The science of testing any medical treatment is complex and each approach provides a specific level of insight depending on the design of the investigation. When assessing evidence, the highest quality evidence that is available is considered first as it is generally believed to provide the most robust information. The reliability (or “robustness”) of clinical evidence broadly relates to the risk of bias as a result of the study design and its publication.