Homeopathy

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The End of Homeopathy?

A British Medical Journal has high hopes

 

Posted Tuesday, Oct. 04, 2005

Millions of people around the world swear by the alternative medicine

homeopathy. In Britain, the Royal Family endorses and uses it. But that hasn't

deterred the editors of The Lancet, the prestigious British medical journal,

which has launched an all-out attack on homeopathy. In its current issue, The

Lancet published a massive study that compared the results of 110 trials of

homeopathy with the same number of trials of conventional medicine. The

conclusion: benefits attributed to homeopathy were, at best, placebo effects.

 

The study is accompanied by an article featuring criticism of a World Health

Organization (WHO) draft report that, as currently written, gives homeopathy

some leeway, as well as a commentary on bias in research and The Lancet's

no-holds-barred editorial comment.

 

Homeopathy was invented by an 18th Century German physician named Samuel

Hahnemann, who argued that diseases could be cured by administering substances,

mostly herbs or minerals, that produce the same symptoms as the disease. And, he

claimed, the effects of these substances could be enhanced by diluting them. How

much? The greater the dilution, it seems, the greater the benefit.

 

That theory, for which there is not a shred of evidence, is evident in the

homeopathic sections of health food stores and major drugstore chains. There,

consumers can see, on the homeopathic containers, such notations as 10X, or 80X

or even 30C. Each X signifies that the active substance has undergone a

ten-to-one dilution, each C a hundred-to-one dilution. Between each dilution,

the solution is shaken vigorously, an action that proponents claim transfers the

properties of the substance to the surrounding water.

 

But by the laws of chemistry, at 24 X there is just a 50 percent chance that s

single molecule of the active substance remains. And at 200C, the dilution of a

popular homeopathic flu remedy, the active ingredient is long gone. What

nonsense!

 

Chances are that The Lancet is somewhat premature in announcing the " death " of

homeopathy, which involves a large and very profitable industry and the loyalty

of many of the consumers it has duped. In fact, The Lancet notes, " " the debate

continues, despite 150 years of unfavourable findings. The more dilute the

evidence for homoeopathy becomes, the greater seems its popularity. "

 

But there are encouraging signs. The Swiss Government, after a five-year trial,

has withdrawn insurance coverage for homeopathy. Even the U.S. National Center

for Complementary and Alternative Medicine, which has been criticized for being

too open to spurious alternative medicine claims, has little good to say abut

homeopathy. Its website states, " Systematic reviews have not found homeopathy to

be a definitively proven treatment of any medical condition. "

 

Now, The Lancet concludes, it's up to the doctors, who " need to be bold and

honest with their patients about homeopathy's lack of benefit. " For

scientifically-literate physicians, that shouldn't be so difficult to do.

 

 

--

 

 

 

 

The Lancet 2005; 366:726-732

 

DOI:10.1016/S0140-6736(05)67177-2

 

Are the clinical effects of homoeopathy placebo effects? Comparative study of

placebo-controlled trials of homoeopathy and allopathy

 

 

Summary

Background

Homoeopathy is widely used, but specific effects of homoeopathic remedies seem

implausible. Bias in the conduct and reporting of trials is a possible

explanation for positive findings of trials of both homoeopathy and conventional

medicine. We analysed trials of homoeopathy and conventional medicine and

estimated treatment effects in trials least likely to be affected by bias.

 

Methods

Placebo-controlled trials of homoeopathy were identified by a comprehensive

literature search, which covered 19 electronic databases, reference lists of

relevant papers, and contacts with experts. Trials in conventional medicine

matched to homoeopathy trials for disorder and type of outcome were randomly

selected from the Cochrane Controlled Trials Register (issue 1, 2003). Data were

extracted in duplicate and outcomes coded so that odds ratios below 1 indicated

benefit. Trials described as double-blind, with adequate randomisation, were

assumed to be of higher methodological quality. Bias effects were examined in

funnel plots and meta-regression models.

 

Findings

110 homoeopathy trials and 110 matched conventional-medicine trials were

analysed. The median study size was 65 participants (range ten to 1573). 21

homoeopathy trials (19%) and nine (8%) conventional-medicine trials were of

higher quality. In both groups, smaller trials and those of lower quality showed

more beneficial treatment effects than larger and higher-quality trials. When

the analysis was restricted to large trials of higher quality, the odds ratio

was 0·88 (95% CI 0·65-1·19) for homoeopathy (eight trials) and 0·58 (0·39-0·85)

for conventional medicine (six trials).

 

Interpretation

Biases are present in placebo-controlled trials of both homoeopathy and

conventional medicine. When account was taken for these biases in the analysis,

there was weak evidence for a specific effect of homoeopathic remedies, but

strong evidence for specific effects of conventional interventions. This finding

is compatible with the notion that the clinical effects of homoeopathy are

placebo effects.

 

Affiliations

 

a Department of Social and Preventive Medicine, University of Berne, Berne,

Switzerland

b Medical Research Council Health Services Research Collaboration, Department of

Social Medicine, University of Bristol, Bristol, UK

c Department of Pharmacology, University of Zürich, Zürich, Switzerland

d Practice Brückfeld, MediX General Practice Network, Berne, Switzerland

 

Correspondence to: Prof Matthias Egger, Department of Social and Preventive

Medicine, University of Berne, Berne, Switzerland

 

 

 

Graham Sorenson

 

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