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Reisman S, Balboul M, Jones T. P-curve accurately rejects evidence for homeopathic ultramolecular dilutions. PeerJ 2019; 7:e6318. [PMID: 30697492 PMCID: PMC6347964 DOI: 10.7717/peerj.6318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 12/16/2018] [Indexed: 11/20/2022] Open
Abstract
Background P-curve has been proposed as a statistical test of evidential value. The distributions of sets of statistically significant p-values are tested for skewness. P-curves of true effects are right-skewed, with greater density at lower p-values than higher p-values. Analyses of null effects result in a flat or left-skewed distribution. The accuracy of p-curve has not been tested using published research analyses of a null effect. We examined whether p-curve accurately rejects a set of significant p-values obtained for a nonexistent effect. Methods Homeopathic ultramolecular dilutions are medicinal preparations with active substances diluted beyond Avogadro's number. Such dilute mixtures are unlikely to contain a single molecule of an active substance. We tested whether p-curve accurately rejects the evidential value of significant results obtained in placebo-controlled clinical trials of homeopathic ultramolecular dilutions. Results P-curve accurately rejected the evidential value of significant results obtained in placebo-controlled clinical trials of ultramolecular dilutions. Robustness testing using alternate p-values yielded similar results. Conclusion Our results suggest that p-curve can accurately detect when sets of statistically significant results lack evidential value.
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Affiliation(s)
- Samuel Reisman
- SUNY Downstate College of Medicine, Brooklyn, NY, United States of America
| | - Mostafa Balboul
- SUNY Downstate College of Medicine, Brooklyn, NY, United States of America
| | - Tashzna Jones
- SUNY Downstate College of Medicine, Brooklyn, NY, United States of America
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Fasce A, Picó A. Conceptual foundations and validation of the Pseudoscientific Belief Scale. APPLIED COGNITIVE PSYCHOLOGY 2019. [DOI: 10.1002/acp.3501] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Angelo Fasce
- Department of Philosophy; University of Valencia; Valencia Spain
| | - Alfonso Picó
- Department of Psychobiology; University of Valencia; Valencia Spain
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Loeb M, Russell ML, Neupane B, Thanabalan V, Singh P, Newton J, Pullenayegum E. A randomized, blinded, placebo-controlled trial comparing antibody responses to homeopathic and conventional vaccines in university students. Vaccine 2018; 36:7423-7429. [PMID: 30352746 DOI: 10.1016/j.vaccine.2018.08.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 08/30/2018] [Accepted: 08/31/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Homeopathic vaccines are licensed in many countries but scientific data to support their use are sparse. The goal of this study was to compare the antibody response of homeopathic and conventional vaccines and placebo in young adults. We hypothesized that there would be no significant difference between homeopathic vaccines and placebo, while there would be a significant increase in antibodies in those received conventional vaccines. METHODS A randomized blinded placebo-controlled trial was conducted where 150 university students who had received childhood vaccinations were assigned to diphtheria, pertussis, tetanus, mumps, measles homeopathic vaccine, placebo, or conventional diphtheria, pertussis, tetanus (Tdap) and mumps, measles, rubella (MMR) vaccines. The primary outcome was a ≥ two-fold increase in antibodies from baseline following vaccination as measured by ELISA. Participants, investigators, study coordinator, data blood drawers, laboratory technician, and data analyst were blinded. RESULTS None of the participants in either the homeopathic vaccine or the placebo group showed a ≥ two-fold response to any of the antigens. In contrast, of those vaccinated with Tdap, 68% (33/48) had a ≥ two-fold response to diphtheria, 83% (40/48) to pertussis toxoid, 88% (42/48) to tetanus, and 35% (17/48) of those vaccinated with MMR had a response to measles or mumps antigens (p < 0.001 for each comparison of conventional vaccine to homeopathic vaccine or to placebo). There was a significant increase in geometric mean titres of antibody from baseline for conventional vaccine antigens (p < 0.001 for each), but none for the response to homeopathic antigens or placebo. CONCLUSIONS Homeopathic vaccines do not evoke antibody responses and produce a response that is similar to placebo. In contrast, conventional vaccines provide a robust antibody response in the majority of those vaccinated. TRIAL REGISTRY NCT 02825368.
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Affiliation(s)
- Mark Loeb
- Department of Pathology and Molecular Medicine, McMaster University, 1280 Main St West, MDCL 3208 Hamilton, Ontario L8S 4K1, Canada; Health Research Methodology, Evidence, and Impact, McMaster University, 1280 Main St West, MDCL 3208 Hamilton, Ontario L8S 4K1, Canada; Institute for Infectious Diseases Research, McMaster University, 1280 Main St West, MDCL 3208 Hamilton, Ontario L8S 4K1, Canada.
| | - Margaret L Russell
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive W Calgary, Alberta T2N4Z6, Canada
| | - Binod Neupane
- Health Research Methodology, Evidence, and Impact, McMaster University, 1280 Main St West, MDCL 3208 Hamilton, Ontario L8S 4K1, Canada
| | - Vitheya Thanabalan
- Department of Pathology and Molecular Medicine, McMaster University, 1280 Main St West, MDCL 3208 Hamilton, Ontario L8S 4K1, Canada
| | - Pardeep Singh
- Department of Pathology and Molecular Medicine, McMaster University, 1280 Main St West, MDCL 3208 Hamilton, Ontario L8S 4K1, Canada
| | - Jennifer Newton
- Department of Pathology and Molecular Medicine, McMaster University, 1280 Main St West, MDCL 3208 Hamilton, Ontario L8S 4K1, Canada
| | - Eleanor Pullenayegum
- Hospital for Sick Childrene, 555 University Avenue Toronto, Ontario M5G 1X8, Canada
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Dupin C, Arsène-Henry A, Charleux T, Haaser T, Trouette R, Vendrely V. Prévalence et attentes de l’utilisation des « médecines alternatives et complémentaires » pendant la radiothérapie en 2016 : étude prospective. Cancer Radiother 2018; 22:682-687. [DOI: 10.1016/j.canrad.2018.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
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Abstract
Pharmacological strategies for pain management have primarily focused on dampening ascending neurotransmission and on opioid receptor-mediated therapies. Little is known about the contribution of endogenous descending modulatory systems to clinical pain outcomes and why some patients are mildly affected while others suffer debilitating pain-induced dysfunctions. Placebo effects that arise from patients' positive expectancies and the underlying endogenous modulatory mechanisms may in part account for the variability in pain experience and severity, adherence to treatment, distinct coping strategies, and chronicity. Expectancy-induced analgesia and placebo effects in general have emerged as useful models to assess individual endogenous pain modulatory systems. Different systems and mechanisms trigger placebo effects that highly impact pain processing, clinical outcomes, and sense of well-being. This review illustrates critical elements of placebo mechanisms that inform the methodology of clinical trials, the discovery of new therapeutic targets, and the advancement of personalized pain management.
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Affiliation(s)
- Luana Colloca
- Department of Pain and Translational Symptom Science, School of Nursing; Department of Anesthesiology, School of Medicine; and Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Maryland 21201, USA;
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Hawke K, van Driel ML, Buffington BJ, McGuire TM, King D. Homeopathic medicinal products for preventing and treating acute respiratory tract infections in children. Cochrane Database Syst Rev 2018; 9:CD005974. [PMID: 30196554 PMCID: PMC6513540 DOI: 10.1002/14651858.cd005974.pub5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Acute respiratory tract infections (ARTIs) are common and may lead to complications. Most children experience between three and six ARTIs annually. Although these infections are self-limiting, symptoms can be distressing. Many treatments are used to control symptoms and shorten illness duration. Most have minimal benefit and may lead to adverse effects. Oral homeopathic medicinal products could play a role in childhood ARTI management if evidence for effectiveness is established. OBJECTIVES To assess the effectiveness and safety of oral homeopathic medicinal products compared with placebo or conventional therapy to prevent and treat acute respiratory tract infections in children. SEARCH METHODS We searched CENTRAL (2017, Issue 11) including the Cochrane Acute Respiratory Infections Specialised Register, MEDLINE (1946 to 27 November 2017), Embase (2010 to 27 November 2017), CINAHL (1981 to 27 November 2017), AMED (1985 to December 2014), CAMbase (searched 29 March 2018), British Homeopathic Library (searched 26 June 2013 - no longer operating). We also searched the WHO ICTRP and ClinicalTrials.gov trials registers (29 March 2018), checked references, and contacted study authors to identify additional studies. SELECTION CRITERIA Double-blind, randomised controlled trials (RCTs) or double-blind cluster-RCTs comparing oral homeopathy medicinal products with identical placebo or self-selected conventional treatments to prevent or treat ARTIs in children aged 0 to 16 years. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included eight RCTs of 1562 children receiving oral homeopathic medicinal products or a control treatment (placebo or conventional treatment) for upper respiratory tract infections (URTIs). Four treatment studies examined the effect on URTI recovery, and four studies investigated the effect on preventing URTIs after one to three months of treatment, followed up for the remainder of the year. Two treatment and two prevention studies involved homeopaths individualising treatment. The other studies used predetermined, non-individualised treatments. All studies involved highly diluted homeopathic medicinal products.We found several limitations to the included studies, in particular methodological inconsistencies and high attrition rates, failure to conduct intention-to-treat analysis, selective reporting, and apparent protocol deviations. We assessed three studies as at high risk of bias in at least one domain, and many had additional domains with unclear risk of bias. Three studies received funding from homeopathy manufacturers; one support from a non-government organisation; two government support; one was cosponsored by a university; and one did not report funding support.Methodological inconsistencies and significant clinical and statistical heterogeneity precluded robust quantitative meta-analysis. Only four outcomes were common to more than one study and could be combined for analysis. Odds ratios (OR) were generally small with wide confidence intervals (CI), and the contributing studies found conflicting effects, so there was little certainty that the efficacy of the intervention could be ascertained. All studies assessed as at low risk of bias showed no benefit from oral homeopathic medicinal products; trials at uncertain and high risk of bias reported beneficial effects.We found low-quality evidence that non-individualised homeopathic medicinal products confer little preventive effect on ARTIs (OR 1.14, 95% CI 0.83 to 1.57). We found low-quality evidence from two individualised prevention studies that homeopathy has little impact on the need for antibiotic usage (N = 369) (OR 0.79, 95% CI 0.35 to 1.76). We also assessed adverse events, hospitalisation rates and length of stay, days off school (or work for parents), and quality of life, but were not able to pool data from any of these secondary outcomes.There is insufficient evidence from two pooled individualised treatment studies (N = 155) to determine the effect of homeopathy on short-term cure (OR 1.31 favouring placebo, 95% CI 0.09 to 19.54; very low-quality evidence) and long-term cure rates (OR 0.99, 95% CI 0.10 to 9.67; very low-quality evidence). Adverse events were reported inconsistently; however, serious events were not reported. One study found an increase in the occurrence of non-severe adverse events in the treatment group. AUTHORS' CONCLUSIONS Pooling of two prevention and two treatment studies did not show any benefit of homeopathic medicinal products compared to placebo on ARTI recurrence or cure rates in children. We found no evidence to support the efficacy of homeopathic medicinal products for ARTIs in children. Adverse events were poorly reported, so conclusions about safety could not be drawn.
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Affiliation(s)
- Kate Hawke
- The University of QueenslandPrimary Care Clinical Unit, Faculty of Medicine288 Herston Road, HerstonBrisbaneQueenslandAustralia4006
| | - Mieke L van Driel
- The University of QueenslandPrimary Care Clinical Unit, Faculty of Medicine288 Herston Road, HerstonBrisbaneQueenslandAustralia4006
- Bond UniversityCentre for Research in Evidence‐Based Practice (CREBP)Gold CoastQueenslandAustralia4229
- Ghent UniversityDepartment of Family Medicine and Primary Health CareCampus UZ 6K3, Corneel Heymanslaan 10GhentBelgium9000
| | - Benjamin J Buffington
- Wide Bay Hospital and Health ServiceDepartment of PaediatricsBundabergQueenslandAustralia4670
| | - Treasure M McGuire
- The University of QueenslandSchool of PharmacyPharmacy Australia Centre of Excellence20 Cornwall Street, WoolloongabbaBrisbaneQueenslandAustralia4102
- Mater Health ServicesMater Pharmacy Services (Practice & Development)South BrisbaneAustralia4101
- Bond UniversityFaculty of Health Sciences and MedicineUniversity Drive, RobinaGold CoastQueenslandAustralia4229
| | - David King
- The University of QueenslandPrimary Care Clinical Unit, Faculty of Medicine288 Herston Road, HerstonBrisbaneQueenslandAustralia4006
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Hawke K, van Driel ML, Buffington BJ, McGuire TM, King D. Homeopathic medicinal products for preventing and treating acute respiratory tract infections in children. Cochrane Database Syst Rev 2018; 4:CD005974. [PMID: 29630715 PMCID: PMC6513633 DOI: 10.1002/14651858.cd005974.pub4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Acute respiratory tract infections (ARTIs) are common and may lead to complications. Most children experience between three and six ARTIs each year. Although these infections are self limiting, the symptoms can be distressing. Many treatments are used to control symptoms and shorten the duration of illness. They often have minimal benefit and may lead to adverse effects. Oral homeopathic medicinal products could play a role in the treatment of ARTIs for children if evidence for effectiveness is established. OBJECTIVES To assess the effectiveness and safety of oral homeopathic medicinal products compared with placebo or conventional therapy to prevent and treat acute respiratory tract infections in children. SEARCH METHODS We searched CENTRAL (2017, Issue 11), which contains the Cochrane Acute Respiratory Infections Specialised Register, MEDLINE (1946 to 27 November 2017), Embase (2010 to 27 November 2017), CINAHL (1981 to 27 November 2017), AMED (1985 to December 2014), CAMbase (searched 29 March 2018), British Homeopathic Library (searched 26 June 2013 - no longer operating). We also searched the WHO ICTRP and ClinicalTrials.gov trials registers (29 March 2018), checked references, and contacted study authors to identify additional studies. SELECTION CRITERIA Double-blind, randomised controlled trials (RCTs) or double-blind cluster-RCTs comparing oral homeopathy medicinal products with identical placebo or self selected conventional treatments to prevent or treat ARTIs in children aged 0 to 16 years. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included eight RCTs of 1562 children receiving oral homeopathic medicinal products or a control treatment (placebo or conventional treatment) for upper respiratory tract infections (URTIs). Four treatment studies examined the effect on recovery from URTIs, and four studies investigated the effect on preventing URTIs after one to three months of treatment and followed up for the remainder of the year. Two treatment and two prevention studies involved homeopaths individualising treatment for children. The other studies used predetermined, non-individualised treatments. All studies involved highly diluted homeopathic medicinal products.We found several key limitations to the included studies, in particular methodological inconsistencies and high attrition rates, failure to conduct intention-to-treat analysis, selective reporting, and apparent protocol deviations. We assessed three studies as at high risk of bias in at least one domain, and many had additional domains with unclear risk of bias. Three studies received funding from homeopathy manufacturers; one reported support from a non-government organisation; two received government support; one was cosponsored by a university; and one did not report funding support.Methodological inconsistencies and significant clinical and statistical heterogeneity precluded robust quantitative meta-analysis. Only four outcomes were common to more than one study and could be combined for analysis. Odds ratios (OR) were generally small with wide confidence intervals (CI), and the contributing studies found conflicting effects, so there was little certainty that the efficacy of the intervention could be ascertained. All studies assessed as at low risk of bias showed no benefit from oral homeopathic medicinal products; trials at uncertain and high risk of bias reported beneficial effects.We found low-quality evidence that non-individualised homeopathic medicinal products confer little preventive effect on ARTIs (OR 1.14, 95% CI 0.83 to 1.57). We found low-quality evidence from two individualised prevention studies that homeopathy has little impact on the need for antibiotic usage (N = 369) (OR 0.79, 95% CI 0.35 to 1.76). We also assessed adverse events, hospitalisation rates and length of stay, days off school (or work for parents), and quality of life, but were not able to pool data from any of these secondary outcomes.There is insufficient evidence from two pooled individualised treatment studies (N = 155) to determine the effect of homeopathy on short-term cure (OR 1.31, 95% CI 0.09 to 19.54; very low-quality evidence) and long-term cure rates (OR 1.01, 95% CI 0.10 to 9.96; very low-quality evidence). Adverse events were reported inconsistently; however, serious events were not reported. One study found an increase in the occurrence of non-severe adverse events in the treatment group. AUTHORS' CONCLUSIONS Pooling of two prevention and two treatment studies did not show any benefit of homeopathic medicinal products compared to placebo on recurrence of ARTI or cure rates in children. We found no evidence to support the efficacy of homeopathic medicinal products for ARTIs in children. Adverse events were poorly reported, so conclusions about safety could not be drawn.
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Affiliation(s)
- Kate Hawke
- The University of QueenslandPrimary Care Clinical Unit, Faculty of Medicine288 Herston Road, HerstonBrisbaneAustralia4006
| | | | | | | | - David King
- The University of QueenslandPrimary Care Clinical Unit, Faculty of Medicine288 Herston Road, HerstonBrisbaneAustralia4006
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Bellavite P, Marzotto M, Bonafini C. Arnica montana experimental studies: confounders and biases? JOURNAL OF INTEGRATIVE MEDICINE-JIM 2018. [PMID: 29526239 DOI: 10.1016/j.joim.2018.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Arnica montana is a popular traditional remedy widely used in complementary and alternative medicine, in part for its wound-healing properties. The authors recently showed that this plant extract and several of its homeopathic dilutions are able to modify the expression of a series of genes involved in inflammation and connective tissue regeneration. Their studies opened a debate, including criticisms to the "errors" in the methods used and the "confounders and biases". Here the authors show that the criticisms raised on methodology and statistics are not consistent and cannot be considered pertinent. The present comment also updates and reviews information concerning the action of A. montana dilutions in human macrophage cells while summarizing the major experimental advances reported on this interesting medicinal plant.
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Affiliation(s)
- Paolo Bellavite
- Department of Medicine, University of Verona, Strada Le Grazie 8, Verona 37134, Italy
| | - Marta Marzotto
- Department of Medicine, University of Verona, Strada Le Grazie 8, Verona 37134, Italy.
| | - Clara Bonafini
- Department of Medicine, University of Verona, Strada Le Grazie 8, Verona 37134, Italy
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Klein SD, Würtenberger S, Wolf U, Baumgartner S, Tournier A. Physicochemical Investigations of Homeopathic Preparations: A Systematic Review and Bibliometric Analysis-Part 1. J Altern Complement Med 2018; 24:409-421. [PMID: 29377709 PMCID: PMC5961874 DOI: 10.1089/acm.2017.0249] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives: The last systematic review of physicochemical research performed on homeopathic preparations was published in 2003. The aim of the study is to update and expand the current state of knowledge in the area of physicochemical properties of homeopathic preparations. In part 1 of the study, we aim to present an overview of the literature with respect to publication quality and methods used. In part 2, we aim to identify the most interesting experimental techniques. With this, we aim to be in a position to generate meaningful hypotheses regarding a possible mode of action of homeopathic preparations. Methods: A two-step procedure was adopted: (1) an extensive literature search, followed by a bibliometric and quality analysis on the level of publications and (2) a thorough qualitative analysis of the individual physicochemical investigations found. In this publication, we report on step (1). We searched major scientific databases to find publications reporting physicochemical investigations of homeopathy from its origin to the end of 2015. Publications were assessed using a scoring scheme, the Manuscript Information Score (MIS). Information regarding country of origin of the research and experimental techniques used was extracted. Results: We identified 183 publications (compared to 44 in the last review), 122 of which had an MIS ≥5. The rate of publication in the field was ∼2 per year from the 1970s until 2000. Afterward, it increased to over 5.5 publications per year. The quality of publications was seen to increase sharply from 2000 onward, whereas before 2000, only 12 (13%) publications were rated as “high quality” (MIS ≥7.5); 44 (48%) publications were rated as “high quality” from 2000 onward. Countries with most publications were Germany (n = 42, 23%), France (n = 29, 16%), India (n = 27, 15%), and Italy (n = 26, 14%). Techniques most frequently used were electrical impedance (26%), analytical methods (20%), spectroscopy (20%), and nuclear magnetic resonance (19%). Conclusions: Physicochemical research into homeopathic preparations is increasing both in terms of quantity and quality of the publications.
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Affiliation(s)
- Sabine D Klein
- 1 Institute of Complementary Medicine, University of Bern , Bern, Switzerland
| | - Sandra Würtenberger
- 2 Scientific & Regulatory Affairs, Hevert-Arzneimittel GmbH & Co. KG , Nussbaum, Germany
| | - Ursula Wolf
- 1 Institute of Complementary Medicine, University of Bern , Bern, Switzerland
| | - Stephan Baumgartner
- 1 Institute of Complementary Medicine, University of Bern , Bern, Switzerland .,3 Society for Cancer Research , Arlesheim, Switzerland .,4 Institute of Integrative Medicine, University of Witten/Herdecke , Witten, Germany
| | - Alexander Tournier
- 1 Institute of Complementary Medicine, University of Bern , Bern, Switzerland .,5 Homeopathy Research Institute , London, United Kingdom
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Mathie RT, Van Wassenhoven M, Rutten ALB, Klein-Laansma CT, Eizayaga J, Pla I Castellsagué A, Jong MC, Manchanda RK, Dantas F, Oberbaum M, Frye J, Roniger H, Baumgartner S, van Haselen R, Nicolai T, Fisher P. Model validity of randomised placebo-controlled trials of non-individualised homeopathic treatment. HOMEOPATHY 2017; 106:194-202. [PMID: 29157469 DOI: 10.1016/j.homp.2017.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/23/2017] [Accepted: 07/31/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND The comprehensive systematic review of randomised placebo-controlled trials (RCTs) in homeopathy requires examination of a study's model validity of homeopathic treatment (MVHT) as well as its risk of bias (extent of reliable evidence). OBJECTIVE To appraise MVHT in those RCTs of non-individualised homeopathy that an associated investigation had judged as 'not at high risk of bias'. DESIGN Systematic review. METHODS An assessment of MVHT was ascribed to each of 26 eligible RCTs. Another 49 RCTs were ineligible due to their high risk of bias. MAIN OUTCOME MEASURES MVHT and the prior risk of bias rating per trial were merged to obtain a single overall quality designation ('high', 'moderate', 'low'), based on the GRADE principle of downgrading. RESULTS The trials were rated as 'acceptable MVHT' (N = 9), 'uncertain MVHT' (N = 10) and 'inadequate MVHT' (N = 7); and, previously, as 'reliable evidence' (N = 3) and 'non-reliable evidence' (N = 23). The 26 trials were designated overall as: 'high quality' (N = 1); 'moderate quality' (N = 18); 'low quality' (N = 7). CONCLUSION Of the 26 RCTs of non-individualised homeopathy that were judged 'not at high risk of bias', nine have been rated 'acceptable MVHT'. One of those nine studies was designated 'high quality' overall ('acceptable MVHT' and 'reliable evidence'), and is thus currently the only reported RCT that represents best therapeutic practice as well as unbiased evidence in non-individualised homeopathy. As well as minimising risk of bias, new RCTs in this area must aim to maximise MVHT and clarity of reporting.
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Affiliation(s)
- Robert T Mathie
- Homeopathy Research Institute, 142 Cromwell Road, London SW7 4EF, UK.
| | - Michel Van Wassenhoven
- Belgian Homeopathic Medicines Registration Committee, FAMHP (Federal Agency for Medicines and Health Products), Belgium.
| | | | | | - José Eizayaga
- Department of Homeopathy, Maimonides University, Buenos Aires, Argentina.
| | | | - Miek C Jong
- Department Nutrition & Health, Louis Bolk Institute, Driebergen, The Netherlands; Department of Health Sciences, Mid-Sweden University, Sundsvall, Sweden; National Information and Knowledge Centre for Integrative Medicine, The Netherlands.
| | | | - Flávio Dantas
- Faculty of Medicine, Federal University of Uberlândia, Uberlândia, Brazil.
| | | | - Joyce Frye
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Helmut Roniger
- Royal London Hospital for Integrated Medicine, London, UK.
| | | | | | | | - Peter Fisher
- Royal London Hospital for Integrated Medicine, London, UK.
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Lees P, Pelligand L, Whiting M, Chambers D, Toutain PL, Whitehead ML. Comparison of veterinary drugs and veterinary homeopathy: part 2. Vet Rec 2017; 181:198-207. [PMID: 28821700 PMCID: PMC5738588 DOI: 10.1136/vr.104279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Part 2 of this narrative review outlines the theoretical and practical bases for assessing the efficacy and effectiveness of conventional medicines and homeopathic products. Known and postulated mechanisms of action are critically reviewed. The evidence for clinical efficacy of products in both categories, in the form of practitioner experience, meta-analysis and systematic reviews of clinical trial results, is discussed. The review also addresses problems and pitfalls in assessing data, and the ethical and negative aspects of pharmacology and homeopathy in veterinary medicine.
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Affiliation(s)
| | | | - M Whiting
- Royal Veterinary College, Hawkshead Campus, Hatfield, Hertfordshire
| | - D Chambers
- Hall Manor, Kelly, Lifton, Devon PL16 0HQ, UK
| | - P-L Toutain
- Toxalim, Ecole Nationale Veterinaire de Toulouse, France
| | - M L Whitehead
- Chipping Norton Veterinary Hospital, Banbury Road, Chipping Norton, Oxon OX7 5SY, UK
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