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LONDON, AUGUST 26:LONDON, AUGUST 26: A study published
in the medical journal Lancet has cast doubt on the power of homoeopathic
remedies. A team of scientists have described them as weak and producing
nothing more than a placebo effect. The research says the benefits
of homoeopathy are all in the imagination of patients. |
They claimed that homeopathy was based on the theory that disease could be fought by massively diluted substances, such as herbs and minerals that provoked similar symptoms. However, the Lancet also reports that a draft report on homoeopathy by the World Health Organization says the majority of peer-reviewed scientific papers published over the past 40 years have demonstrated that homoeopathy is superior to placebo in placebo-controlled trials. |
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Dr. Matthias Egger, from the University
of Berne in Switzerland, and associates searched 19 electronic databases
covering the period from 1995 to 2003 to identify scientific trials of
homoeopathy, and matched them with trials in conventional medicine. They
compared 110 trials that looked at the effects of homoeopathy versus placebo
with 110 trials of conventional medicines for the same medical disorders
or diseases.
Homoeopathy,
of German origin, is widely recognized in Europe, with the late Queen
Mother Elizabeth being its most famous supporter. Interest is gradually
growing in America, as well. Despite royal backing from Prince Charles,
homoeopathic remedies have come under fire by medical researchers.
Many previous studies have demonstrated that homoeopathy has an effect
over and above placebo. Many homoeopaths and Research scholars’
comment “It has been established beyond doubt and accepted by many
researchers, that the placebo-controlled randomised controlled trial is
not a fitting research tool with which to test homoeopathy.”
“This is not the first time the prestigious journal has been at
the center of controversy over scientifically flawed research. The Lancet
previously published a sensationalized study linking autism and the MMR
vaccine, which many feel is responsible for eroding public faith in the
MMR vaccine and leading to declining use and new outbreaks of measles
in the UK. The journal later stated that in hindsight, it would not have
published the flawed study” Dr. Cathy Wong
Homoeopaths allege pharma lobby behind campaign to portray homoeopathy
ineffective. They say “Research Bias “ is based on growing
interest in Homoeopathy may damage the pharmaceutical world, as the drug
that costs $300 for allopathic treatment may cost $30 in homoeopathy,
as reported by one of the pharmaceutical magazine.
SOURCES:
- The Lancet, Aug. 27, 2005; Vol 366: pp 726-732.
Article -Are the clinical effects of Homoeopathy placebo effects?
- The Lancet, Aug. 27, 2005; Vol 366: pp 691-692.
Comment – Homoeopathy and “the growth of truth”
- The Lancet, Aug. 27, 2005; Vol 366: pp 690
Editorial -The end of Homoeopathy
- The Lancet, Aug. 27, 2005; Vol 366: pp 705-706
World Report –Critics slam draft WHO report on homoeopathy.
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NEW DELHI, AUGUST 27. The
Indian government has written to the British medical journal The
Lancet, questioning its report which says there is no scientific
proof that homeopathy is effective. Dr Anbumani Ramadoss, Union
Minister for Health and Family Welfare on the lancet controversy: |
“India is the largest
user of homoeopathic medicines and it is becoming increasingly popular
everyday. Publishing studies like this creates panic. Even in the
past a Journal of American Medical Association study on lead and
mercury toxicity was splashed all over the international media.
We are planning to write to Lancet and other journals and ask them
for original research papers. This is a scientific thing we will
counter it in a scientific manner by sending our own findings.” |
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Uma Pillai, secretary AYUSH, Ministry of Health told “ It is very unfair to say the system doesn’t work. It can’t be there for centuries if it was such a miserable fake. We need to know what kind of a study it is. We have to see if pharma companies are behind the study” Not surprisingly, homeopaths have reacted strongly to the article, saying it is nothing but a jugglery of vague statistics . |
”When
the quantity of medicine is reduced or diluted, its disease-curing power
is enhanced,” said Dr. Raj Kumar Manchanda, Deputy Director, Directorate
of ISM & Homeopathy.
“The
answer lies in the article itself. In 1997, Lancet itself informed the
public that homoeopathy is as good as any recognised system. What will
you believe? We need to know how they evaluated. Standards for allopathic
trials are different, the researcher has to have clear knowledge of the
science. If four people have migraine, homoeopathy treats them in four
different ways. We need to know whether they showed the data to homoeopathic
experts” S.P. Singh, Advisor Homeopathy, Govt of India expressed
his views
A draft report on homoeopathy prepared by the department of essential drugs and medicines policy at the World Health Organization came under criticism in The Lancet entitled “Homoeopathy: review and analysis of reports on controlled clinical trials”, says that the majority of placebo controlled clinical trials of homeopathy published over the past 40 years have shown that it is superior to placebo and equivalent to conventional medicines in the treatment of illnesses in humans and animals.
However, Professor Ernst told that the draft seems “overtly biased, ie, it is based on data that are positive while ‘forgetting’ the negative studies and systematic reviews.” He added that the trials cited are not the most recent or the most rigourous.
Xiaorui Zhang, acting team co-ordinator for traditional medicine
at the WHO, said that the reports on traditional medicines are aimed at
improving research approaches and appropriate clinical studies and should
be used only as references, not taken to be recommendations. The draft
report is currently undergoing revision and its publication date is not
known, she added.
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Prominent U.S. scientists
strongly rejected findings on homoeopathic medicine appearing
in the Aug. 27, 2005 edition of the Lancet. The study in question
was the work of Aijing Shang and colleagues from the University
of Berne in Switzerland. The U.S. scientists rejecting the conclusions
of the study are Dr. Rustum Roy Ph.D. (Penn State University), Dr.
Iris Bell, M.D., Ph.D. (University of Arizona) and Dr. Joyce Frye
D.O., M.B.A. (University of Pennsylvania). |
Shang et al. have successfully
applied a methodological approach to the articles they reviewed
that is highly suitable for drawing conclusions about conventional
medicine but is incomplete in evaluating homoeopathic medicine.
They did not include criteria that would apply to high quality homoeopathic
research reflecting the nature of homeopathic practice. Such criteria
include consideration of the quality the homoeopathy provided”,
said Iris Bell, M.D., Ph.D. |
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“Furthermore,
a single remedy selection for a given conventionally-diagnosed condition
is not homeopathy, yet there are numerous conventionally-judged high
quality studies that were so designed. The analogy would be to test
the effects of penicillin for all patients with symptoms of an apparent
infection. The quality of the studies would otherwise be excellent in
design. However, penicillin will not work for patients with viral infections
or bacterial infections resistant to its effects or for persons with
fevers from other non-infectious causes - and it thus might show benefit
only for a subset of patients with symptoms of infections, i.e., the
ones with true penicillin- sensitive infections. How would penicillin
fare in a meta-analysis of studies designed to ignore the intrinsic
nature of penicillin in benefiting patients,” said Bell.
Joyce
Frye DO, MBA commented that the study’s authors seemed to begin
their work with a bias. “While their analysis clearly showed effects
of homoeopathic treatment, they found ways to disregard those. Out of
the millions of trials in conventional medicine, their primary outcome
relied on the comparison of ridiculously small numbers, 8 trials of
homoeopathy and 6 trials of conventional medicine. They began their
work with the assumption ‘that the effects observed in placebo-controlled
trials of homoeopathy could be explained by a combination of methodological
deficiencies and biased reporting’. Sound research is not conducted
from this starting position.”
Among other topics, the Lancet challenges the plausibility of homoeopathic effects given that homoeopathic remedies are often administered in dilutions in excess of Avagadro’s number. Dr. Rustum Roy, Ph.D. distinguished material scientist from Penn State University commented that the chemistry argument made in this study and by conventional medicine in general is false science. “The underpinning of the editorial content of the Lancet as it relates to homoeopathy relies on a quaint old idea from the nineteenth century that the ONLY way that the property of water can be affected or changed is by incorporating foreign molecules.”
“This is the Avagadro-limit high-school level chemistry argument. To a material scientist this notion is absurd, since the fundamental paradigm of material-science is that the structure-property relationship is the basic determinant of everything. It is a fact of the structure of water and therefore the informational content of water can be altered in infinite ways.
Courtesy
: http://www.usnewswire.com/
U.S. Newswire
NEWTOWN SQUARE, Pa., Aug 30, Boiron Laboratories has rejected editorial commentaries and an article published in The Lancet on the basis it has methodological errors. The British medical journal features commentary and a study by Aijing Shang and colleagues from the University of Berne in Switzerland. |
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The study was based on 220 studies, which were selected according to pre-defined and scientific criteria. This first global analysis actually validates the conclusion of three previous meta-analyses that homoeopathic medicines are effective.
- Clinical Trials of Homoeopathy. British Medical
Journal (1991).
- Report to the European Commission (1996).
A Meta-Analysis of Placebo- Controlled Trials, The
Lancet (1997).
Conversely, the authors of the study
arbitrarily eliminated a number of trial series, retaining only 14 out
of the 220 initial studies (eight trials of homoeopathy and six trials
of conventional medicines), which led to final conclusions that are unfavorable
to homoeopathy. This sub-group analysis, made subsequent to the first
global analysis and based on unknown trial selection criteria, is unscientific
and not rigorous.
Homoeopathic medicines are prescribed by 150,000 physicians to 300 million patients throughout the world. The publication of this subject matter has arisen at a time when a preliminary World Health Organization report on homoeopathy has drawn conclusions that are favorable to homoeopathy.
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Naples, Italy, Sept.19:
Health Minister Francesco Storace, in Naples to attend a National
Alliance local meeting on healthcare, bites back, after the daily
‘La Repubblica’ published an article on an alleged prohibition
of turning to homoeopathic cures, set by his ministry. |
“We support the right to choose a cure, and that includes homoeopathy. The papers mentioned are simply a request of the EU to take up a specific law. We forwarded the study of the Lancet to the Superior Healthcare Council, regarding homoeopathy and placebo. It was our duty to do so. I personally believe in the soundness of homoeopathy, as 9 mln Italians do. So, this is much a do about nothing”. (AGI).
The popular news channel NDTV has hosted a opinion poll forum in “Doctor NDTV” online edition. The title “ Do you think Homoeopathy is effective? “ has scored 86% positive that homoeopathy is effective.
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Ludhiana,
August 9: THE Advance Scientific
Homeopathic Association has welcomed the election of Dr. Paramjeet
Singh Ranu as chairman of the Punjab Homeopathic Council and a member
of the Central Council for Homeopathy. |
Dr. Ravinder Kochar, principal of Lord Mahavira College of Homeopathy, Dr. Daljeet Sharma, Dr. Vipin Gupta, Dr. Naurag Sood, Dr. Rajan Kapil, Dr Naveen Sharma, Dr Gaurav Jain and other members of the association have congratulated Dr.Ranu on his election.
The article by Shang et al (1) concludes that their findings are compatible with the notion that the clinical effects of homoeopathy are placebo effects but it raises more questions than answers. In this report the authors thoroughly examine 110 trials of homoeopathy and 110 matched trials of allopathic medicine, comparing effects and the looking for presence of bias resulting from inadequate methods and selective publication.
When they examined the 220 trials they find no evidence of more bias in the homoeopathy trials than in the allopathy trials. They then go on to estimate the treatment effects in a very small subset of 14 trials that they seem to be least likely to be affected by bias and base their conclusions upon these estimates. Of the total 220 trials the authors identify 21 homoeopathy trials and 8 allopathic trials that are of higher standard according to their own set criteria. They then proceed to further select the small subset of purportedly larger and higher methodological quality trials (8 homoeopathy trials and 6 conventional medicine trials) from which the paper’s conclusions are drawn. The authors do not provide an explanation as to how they chose the particular cut off point that they used to select the 14 trials nor do they provide reference for the selected trials.
Since this small subset of trials form the basis for their conclusions it merits more explanation in description of method and is of fundamental importance when assessing validity of the authors’ conclusions for many reasons including the following:
* The authors generalise from an extremely small pool of data to draw their apparently broad and damning conclusions.
* Identification of the particular trials that are used in the final analysis would enable a fair critique of the validity of the included trials.
The conflict between internal and external validity which plagues research in CAM has resulted in some homoeopathy trials being of high internal validity but bearing little or no resemblance to the practice of homoeopathy leading to spurious results. Such results may then feed into wider meta-analyses when selection criteria are based purely upon internal validity as is the case in this study. Elucidation of the rationale for choosing this small number of studies as well as a list of which studies this seemingly comprehensive interpretation was drawn from is essential. Other questions that this piece of research raises:
- The authors conclusions are premised upon the supposition that the
placebo controlled randomised trial represents the gold standard against
which all research should be judged. It is becomingly increasingly
understood that there are considerable problems in using this method
to test complex interventions such as homoeopathy
- It is always going to be difficult to adopt reductionist research
method of RCT to measure effects of complex intervention such as homoeopathy.
Two primary concerns for homoeopaths are that the treatment is holistic
and that it is individualised. Treatment cannot be standardised and
patient response is unpredictable. Some patients may take months to
show any improvement. RCTs are looking for specific effects whereas
homoeopathy is attempting to treat the whole person.
- Many different types of prescribing method for homoeopathy trials
are all considered equally. Of the 100 trials selected only 18 (16%)
deemed classical homoeopathy i.e. the type of individualised prescribing
that occurs in real life and there is no indication of how many of
the selected 8 trials involved this type of prescribing
- The authors define 4 different types of homoeopathic intervention
whilst the majority of the allopathic trials are pharmaceutical. Hence
in their attempt to match pairs of trials the authors will have been
forced to match some homoeopathy trials of complex intervention with
simple intervention of the allopathic trials.
- Assessment of study quality focuses upon 3 key domains of internal
validity with apparently no regard to external validity. Hence the
selected trials may have been deemed highest quality without actually
bearing any relation to the practice of homoeopathy.
- Any meta-analysis of homoeopathy will necessarily be considering
only a small number of trials as there are relatively few for any
one condition. This leads to the pooling of heterogeneous data.
- The authors display their own bias in interpretation when they dismiss
out of hand the substantially beneficial pooled effect from 8 trials
of homoeopathic remedies in upper respiratory tract infections. This
in spite of the fact that the trials perform well in the authors own
set test of funnel plot asymmetry which demonstrated that there was
no significant difference between effects in the higher quality trial
and the lower quality trials. Here the authors speak of biases prevalent
in these publications to excuse the effect without specifying in any
way how they relate to these trials and indicate that conclusions
from these trials cannot be trusted.
- 21 homoeopathy trials and 9 allopathic are identified as being of
higher quality, why are so few allopathic trials of higher quality?
We know that research in homeopathy is seriously under-funded and
undermanned but this is not the case for pharmaceutical research.
- Since they have already established that a far higher percentage of homoeopathy trials (21%) than allopathy trials (8%) were of highest quality it does beg the question as to how we are ever able to trust the conclusions of allopathic drug trials.
Conclusion
Far from being the ultimate test of homoeopathy this meta-analysis leaves many questions unanswered. In summary, the conclusions that the authors draw are premised upon the supposition that the placebo-controlled RCT is the highest standard against which we should measure quality of research method, and takes no account of the complex nature of the homoeopathic intervention. In addition, broad conclusions are drawn from a small pool of data from a total of 8 homoeopathy trials and 6 allopathic trials. The trials selected for final analysis are not referenced and we are therefore unable to establish their external validity and verify the authors statements that these represent trials of homoeopathy of highest quality available.
Kate
Chatfield, Clare Relton,
ECCH Research Academics and Homoeopaths
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LONDON.AUGUST.24:
According to media in the UK, Prince Charles has commissioned a
report into how the government could save money by using alternative
medicine in the public healthcare system . The report, led by Christopher
Smallwood, a former chief economics adviser to Barclays Bank, will
be sent to ministers and officials in October. |
A draft of its conclusions, suggests that “economy-wide” savings apparently up to 480 million pounds could be saved if 1 in 10 family doctors offered homoeopathy as an alternative to standard drugs, and savings of up to 3.5 billion pounds could be achieved by offering spinal manipulation rather than drugs to people with back pain. Prince Charles has given the go-ahead for a major report into the money-saving benefits of complementary therapies for Britain’s free-care-for-all National Health Service (NHS),
LONDON,SEP.26. The report published in the Lancet on homoeopathy on 26 August has been questioned by the Faculty of Homoeopathy - the professional body that brings together GPs and hospital doctors who also practise homoeopathy.
Dr. Peter Fisher, Clinical Director of the Royal Homoeopathic Hospital, London said: “Having read this report, the figures do not stack up. The much-trumpeted conclusion about homoeopathy being only a placebo is based on not 110 clinical trials, but just eight. My suspicion is that this report is being selective to try to discredit homoeopathy.”
In many conditions the effectiveness of homoeopathy is supported by randomised clinical trials including asthma, fibrositis, influenza, glue ear, muscle soreness, pain, side-effects of radiotherapy, sprains and upper respiratory tract infections.
Doctors train in and practise homoeopathy precisely because a “disease-focused technology driven medical model” does not provide all the answers. Doctors working at the five NHS homoeopathic hospitals have at their disposal all the tools of both conventional and homoeopathic medicine but choose to use homoeopathy where most appropriate for the patient.Sally Penrose, Chief Executive of the Faculty of Homoeopathy said: “Patient outcome studies at the NHS homoeopathic hospitals show that on average 70% of patients report positive health changes after homoeopathic treatments - these are patients who have usually exhausted all the conventional options first and are coping with intolerable suffering.”
MUSCAT, AUGUST 28: Placebo? Would a one-month-old baby get cured of a strep throat if the clinical effects of homoeopathy were comparable to only placebo effects? And how would a placebo have an effect on a one-month-old baby? There are homoeopaths who treat animals. Could placebo action be induced in animals too? So how can homoeopathy be dismissed in such a manner ?
Muscat-based homoeopaths listed out yesterday a whole array of diseases that have been completely cured by homoeopathy. Nothing breeds like success (other than success), which was, indeed, the final effect of homoeopathic treatment in many cases, they stressed.
That a homoeopath was successful in treating thousands of patients for many years itself pointed out to the fact that it worked wonders, said some of the homoeopaths based in Muscat, while others asked how a college like the Royal College of Homoeopathy could exist in London without homeopathic treatment proving that it was successful.
“Do you think the UK government is foolish to invest money in a college like that if it only had placebo effects?” an irate homoeopath asked. In fact, other than millions of common men, women and children, celebrities, famous personalities, including the likes of the Queen of England, former US president Bill Clinton, Mahatma Gandhi and Indira Gandhi, have benefited from homoeopathy. There are thousands of other equally respected individuals who swear by homoeopathy.
Was a mere study going to debunk all that? Besides, even allopathic doctors have bridged the divide by opting for homoeopathy themselves. There are many cases in Oman where senior allopathic doctors refer patients whom they are unable to treat to the homoeopathy segment. What does this all indicate, a section of homoeopaths here query. Agreed, it may not be a panacea for all ailments, but neither can a 200 years-old science be summarily debunked and dismissed as though it were a schoolboy play science perpetrated by five-year olds.
Practitioners and adherents to homoeo pathy reacted in an explosive manner yesterday when confronted with the study, recently published in Lancet medical journal, which said homoeopathy does not work.
Many could not believe what they read and their reactions bordered on anger and sheer incredulity. On what basis was the study dismissing homoeopathy, they queried, and supporting them in spirit, and otherwise, were patients who benefited from this science and who, while pledging their support for homoeopathy, voiced their anger against such studies. Local homoeopaths, while being up in arms against the study they dismissed as ‘baseless’, also argued that this was the handiwork of a few that benefited from such false statements and allegations.
While many suspected the existence of a probable nexus between the study promoters and those who published and highlighted such ill-researched and false statements, many wondered aloud as to how a respected medical journal like Lancet stooped to such low standards.
In fact, the day is not far off when the tables
are going to be turned. The writing is on the wall, they added, for
the truth is that allopathy is straining under the pressure of innumerable
medical maladies, which they are unable to cure or even control.
A human body and its entrails are actually designed so that the medical
problems that it face may be cured by alternate methods like homoeopathy,
others note. And as allopathic treatments stumble in the dark, trying
to find a foothold in the unlit caverns of medical science, the only
method of keeping itself alive is to take ugly swipes at alternative
medicine.
These jabs, however painful they may be to those
at the receiving end, only succeeded in revealing the dark underbelly
of failures by those performing conventional interventions, incensed
homoeopaths conclude. It only reveals their standards, they reiterated.