Research in Homeopathy, Table 1: Comprehensive meta-analyses of research in homeopathy

Table 1: Comprehensive meta-analyses of research in homeopathy

Kleijnen et al. 1991 ⁶
British Medical Journal. 105 trials. Criteria-based meta-analysis.

77% of trials showed positive results for homeopathy
Positive trend in favour of homeopathy regardless of trial quality, though percentage of positive findings lower in trials with better research methods (68% positive results).
In the authors' view, the research evidence 'would probably be sufficient for establishing homeopathy as a regular treatment for certain indications'.
'There is a legitimate case for further evaluation of homeopathy'.

Boissel et al. 1996 ⁷
Report for European Commission. 15 trials. Very strict inclusion criteria. Meta-analysis; data synthesis by combining the significance levels (P-values) for the primary outcomes from each trial.

Combined P value for the 15 trials was highly significant (P = 0.0003), although the result not significant for the 9 'highest quality' trials (pooled P = 0.18).
'There is evidence that homeopathic medicine is more effective than placebo'.
Little evidence of publication bias.
Further high quality studies are needed.

Linde et al. 1997 1 ¹
The Lancet. 89 placebo-controlled trials. Meta-analysis; data synthesis by combining odds ratios.

Combined odds ratio 2.45 (95% CI, 2.05-2.93) in favour of homeopathy.
Mean odds ratio for 26 best quality studies was 1.66 (95% CI, 1.33-2.08).
Some evidence of publication bias in the available literature.
The results 'are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo'.
'Insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition.'
Further research is warranted, provided it is rigorous and systematic.

Linde and Melchart 1998 ⁸
Journal of Alternative and Complementary Medicine. 32 trials of individualized homeopathy reviewed, 19 included in meta-analysis.

Individualized homeopathy was significantly more effective than placebo (pooled rate ratio 1.62 [95% CI, 1.17-2.23]).
Results for "best quality" trials results were not significant (pooled rate ratio 1.12 [95% CI, 0.87-1.44]).
Promising results should be subject to replication.
Pragmatic research design, rather than placebo-controlled research, is indicated.

Cucherat et al. 2000 ⁹
European Journal of Clinical Pharmacology. 16 trials, representing 17 comparisons with placebo included. Pooling of P values (significance of results) reporting least optimistic result from 7 methods of combining significance of results

Highly significant result for 17 comparisons (pooled P = 0.00004), although the result not significant for the five 'best quality' trials (pooled P = 0.08).
" There is some evidence that homeopathic treatments are more effective than placebo, but the strength of this evidence is low because of poor trial quality.
Publication bias unlikely.
More well-designed and well-run clinical trials are needed.

Shang et al. 2005 ⁸¹
The Lancet. 110 placebo-controlled trials of homeopathy and 110 trials of conventional medicine, matched for disorder and type of clinical outcome. Detailed meta-analysis on total of 14 'large trials of higher quality'. Data synthesis by combining odds ratios (an odds ratio of less than 1.0 indicates an effect greater than placebo).

Similar overall positive treatment effect in homeopathy and conventional medicine.
21 homeopathy trials and 9 in conventional medicine judged 'of higher quality'.
Key analysis restricted to 14 'large trials of higher quality' (8 homeopathy, 6 conventional medicine).
Mean odds ratio 0.88 (95% CI, 0.65-1.19) for 8 homeopathy trials, and 0.58 (95% CI, 0.39-0.85) for 6 conventional medicine trials.
'Weak evidence for 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.'

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		Table 1: Comprehensive meta-analyses of research in homeopathy
		Kleijnen et al. 1991 ⁶ British Medical Journal. 105 trials. Criteria-based meta-analysis. 77% of trials showed positive results for homeopathy Positive trend in favour of homeopathy regardless of trial quality, though percentage of positive findings lower in trials with better research methods (68% positive results). In the authors' view, the research evidence 'would probably be sufficient for establishing homeopathy as a regular treatment for certain indications'. 'There is a legitimate case for further evaluation of homeopathy'. Boissel et al. 1996 ⁷ Report for European Commission. 15 trials. Very strict inclusion criteria. Meta-analysis; data synthesis by combining the significance levels (P-values) for the primary outcomes from each trial. Combined P value for the 15 trials was highly significant (P = 0.0003), although the result not significant for the 9 'highest quality' trials (pooled P = 0.18). 'There is evidence that homeopathic medicine is more effective than placebo'. Little evidence of publication bias. Further high quality studies are needed. Linde et al. 1997 1 ¹ The Lancet. 89 placebo-controlled trials. Meta-analysis; data synthesis by combining odds ratios. Combined odds ratio 2.45 (95% CI, 2.05-2.93) in favour of homeopathy. Mean odds ratio for 26 best quality studies was 1.66 (95% CI, 1.33-2.08). Some evidence of publication bias in the available literature. The results 'are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo'. 'Insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition.' Further research is warranted, provided it is rigorous and systematic. Linde and Melchart 1998 ⁸ Journal of Alternative and Complementary Medicine. 32 trials of individualized homeopathy reviewed, 19 included in meta-analysis. Individualized homeopathy was significantly more effective than placebo (pooled rate ratio 1.62 [95% CI, 1.17-2.23]). Results for "best quality" trials results were not significant (pooled rate ratio 1.12 [95% CI, 0.87-1.44]). Promising results should be subject to replication. Pragmatic research design, rather than placebo-controlled research, is indicated. Cucherat et al. 2000 ⁹ European Journal of Clinical Pharmacology. 16 trials, representing 17 comparisons with placebo included. Pooling of P values (significance of results) reporting least optimistic result from 7 methods of combining significance of results Highly significant result for 17 comparisons (pooled P = 0.00004), although the result not significant for the five 'best quality' trials (pooled P = 0.08). " There is some evidence that homeopathic treatments are more effective than placebo, but the strength of this evidence is low because of poor trial quality. Publication bias unlikely. More well-designed and well-run clinical trials are needed. Shang et al. 2005 ⁸¹ The Lancet. 110 placebo-controlled trials of homeopathy and 110 trials of conventional medicine, matched for disorder and type of clinical outcome. Detailed meta-analysis on total of 14 'large trials of higher quality'. Data synthesis by combining odds ratios (an odds ratio of less than 1.0 indicates an effect greater than placebo). Similar overall positive treatment effect in homeopathy and conventional medicine. 21 homeopathy trials and 9 in conventional medicine judged 'of higher quality'. Key analysis restricted to 14 'large trials of higher quality' (8 homeopathy, 6 conventional medicine). Mean odds ratio 0.88 (95% CI, 0.65-1.19) for 8 homeopathy trials, and 0.58 (95% CI, 0.39-0.85) for 6 conventional medicine trials. 'Weak evidence for 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.' << Back to text		Table of contents Homeopathy: the great debate Clinical research in homeopathy Veterinary homeopathy Issues and controversies Mechanism of action Is homeopathy safe? Is homeopathy cost effective? BHA/Faculty’s research strategy References Research discussion forum C O N T A C T U S S I T E M A P H O M E
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