Transcript Overview of the current state of the research in Homeopathy

Overview of the current state of
the research in Homeopathy
Dr Alexander Tournier
BSc Cantab PhD LCHE RSHom
Aims

To show that science and homeopathy are
indeed compatible

To present evidence coming from different
fields of science

To present Homeopathy Research
Institute
Definition of ‘Science’
“Any system of knowledge that is
concerned with the physical world and its
phenomena and that entails unbiased
observations and systematic
experimentation. ”
Encyclopaedia Britannica
Scientific discovery process
Observation
Science of
Homeopathy
Experimentation
Theories
Understanding
Unscientific argumentation
“Homeopathy does not work …
… because it cannot work”
is not scientific,
as it is not grounded in observation
Science of homeopathy
Hahnemann built homeopathy following a
rigorous scientific approach:

Experimentation

Theories and concepts
◦ Provings
◦ Clinical experience
◦ Law of similars
◦ Principle of dilution
◦ Concept of the vital force
Different scientific approaches
Pharmaceutical model
CAM model
Screening
Practice
Mechanism
Safety
Trials of efficacy
Effectiveness
Effectiveness in practise
Efficacy of components
Safety
Mechanism of action
Adapted from Fonnebo etal BMC Med Res Meth 2007 11(7) 7
Homeopathy: a new science
Number of scientific publications over the last 20 year
Adhami H.R. , S.Shamloo D., Mesgarpour B., H.Tehrani S.A.
“The trend of homeopathic articles indexed in pubmed and ISI” LMHI 2008
Scientific evidence in Homeopathy

Materials sciences

Molecular and cellular systems

Animal studies

Human studies
Evidence from Material Sciences

NMR evidence (5/5 Hi-Qt* pub)


Low temp thermoluminescence

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Raman and UV-Vis Spectroscopy


Dielectric strength

*Quality assessed using SAPEH scores, high-quality > 6
Review: C Witt etal J Alt Comp Med 2003 9:1, 113-32
Molecular and cellular systems

Enzymatic reactions (7/9 Hi-Qt* pub)


Cultured cells

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Basophil degranulation
(5/9 Hi-Qt pub)
(8/11 Hi-Qt pub)
*Quality assessed using SAPEH scores, high-quality > 6
C Witt etal Comp Ther Med, 2007 15 128-38

Animal systems

One review in 1998 (no access)

One review in immunology in 2006
◦ Immunostimulation (16 pub)
◦ Immunoregulation, inflammatory processes
(20
pub)

No systematic review in this area despite
wide use and high number of experiments

Effect of thyroxin on frog development

Human trials

134 RCT have been published
◦ 59 (44%)
◦ 67 (50%)
◦ 8 (6%)

positive
neutral (small effect)
negative
23 systematic reviews
◦ 10 positive
◦ 8 non-conclusive
◦ 5 little or no evidence
P. Fisher ‘Research in Homoeopathy: Who needs it’ LMHI 2008
Human provings
or Human pathogenetic trials

Only one review up to 1995
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More recent trials are of higher quality

Need a review of the recent provings

Need more trials

Human provings
A successful example
Average number of Symptoms
Associated p = 0.0002
14
12
10
Arsenicum specific symptoms
Nat-mur specific symptoms
Non-specific symptoms
8
6
4
2
0
-2
-4
Arsenicum
group
Nat-mur
group
Placebo
group
Adapted from H. Möllinger
‘Homeopathic Drug Provings between historical and scientific demand’ LMHI 2008
Meta-analyses
105 studies
+
Boissel etal 1996
15 Hi-Qt studies
+
Linde etal 1997*
89 studies
+
Linde & Melchart 1998*
32 Hi-Qt studies
+
Cucherat etal 2000*
16 Hi-Qt studies
+
8 (110) studies
- (+?)
Kleijnen etal 1991
Shang etal 2005
*Included in UK DARE
(Database of Abstracts of Reviews of Effects)
Shang etal 2005 Meta-analysis

Conclusions based on comparison of 8
homeopathy vs. 6 conventional medicine
trials, not 110 vs. 110

Criteria for selection of 8 high-quality
trials were not given and no references
were given

Does not conform with QUOROM
guidelines for systematic reviews

Not classified as a systematic review by
UK DARE (Database of Abstracts of Reviews of
Effects)
Levels of evidence
Level I
meta-analyses and/or systematic reviews
Level IIa
multiple controlled, randomised
experiments
Level IIb
some controlled, randomised experiments
Level IIIa studies with multiple cohorts
Level IIIb some cohort studies
Level IV
opinion of experts
From Michel van Wassenhoven LMHI 2008
Levels of evidence

Material sciences
IIa+

Molecular and cellular
IIa+

Animals
IIIa / IIb
(one systematic review)
(one systematic review)
Levels of evidence for human trials
I
Overall (Meta analyses 5/6)
I
Allergic rhinitis, post-operative ileus,
rheumatoid arthritis,
protection from toxic substances
IIa
IIb
Asthma, fibrosis, influenza,
muscular pain, otitis media, strains
ENT infections, side effect radiotherapy
Anxiety, ADHD, IBS, migraine,
osteo-arthritis, PMS, Post-tonsillectiomy analgesia,
nausea during chemotherapy, septicaemia
Michel van Wassenhofen, ECH publication LMHI 2008
Conclusions

A lot of scientific evidence exists

However, a lot of it is still of low quality

Need more studies, esp. animal studies

Many questions remain
 Still need a lot of research
Homeopathy Research Institute
Aims:
◦ To perform and promote high-quality
scientific research in homeopathy
◦ To collate, clarify and disseminate the existing
scientific evidence in homeopathy
Homeopathy Research Institute
Scientific committee
Dr Alexander Tournier PhD
Clare Relton MSc
Dr Robert Mathie PhD
Dr Elizabeth Thompson BAOxon MBBS MRCP FFHom
Prof. Kate Thomas
Dr Lionel Milgrom PhD
Dr Mike Emmans Dean PhD
Dr Nagin Lad PhD
Dr Natasa Peric-Concha PhD
Dr Patti Bayliss MBChB FRCGP
Homeopathy Research Institute
Current projects
◦ Curated database of research articles
◦ National survey of homeopathy practice
◦ Scientific expertise for new research projects
◦ Homeopathy use in breast cancer patients
◦ Membership scheme
Thank you
For more information:
[email protected]
www.homeopathyresearchinstitute.org