Julkaisut ja meta-analyysit

[Yllapito]

A meta-analysis is a means of combining results from more than one trial to look for overall trends.
(NB! In general complicated research terminology such as OR, CI, and words such as significant or
randomized  should  only  be  used  in  communications  with  people  who  will  understand  such
terminology. Otherwise stick  to what can be understood by all, e.g. a survey of all  the high quality
research that has been carried out clearly shows that homeopathy is effective.)

Results  were  found  in  favour  of  homeopathy  in  20  of  22  systematic  reviews  on  the  effect  of
homeopathic high-potencies on cells or  living organisms. For upper  respiratory  tract  infections and
allergies six out of seven studies were in favour of homeopathy. The authors of this article concluded
that the effectiveness of homeopathy can be supported by clinical evidence and treatment is safe.

The article has been published by authors who took part of the Program for Evaluation of Complementary
Medicine (PEK), the same program which in August 2005 resulted in the publication of an article by
Shang et al, where the conclusion was that the effect of homeopathy is placebo.
Bornhöft  et al. Effectiveness, Safety and Cost-Effectiveness of Homeopathy  in General Practice –
Summarized Health Technology Assessment. Forsch Komplementärmed 2006;13(suppl 2):19-29.

In  a  review  of  homeopathy  research  the  authors  found  three  independent  systematic  reviews  of
placebo-controlled trials on homeopathy that reported effects that seem to be more than placebo, and
one review that found its effects consistent with placebo.
Jonas,  W.  B.,  Kaptchuk,  T.  J.,  &  Linde,  K.  2003b,  "A  critical  overview  of  homeopathy",
Ann.Intern.Med., vol. 138, no. 5, pp. 393-399.

A systematic review and meta-analysis showed highly significant results for surveys adding up  to a
total  of  2  617  patients  (P=0.000036). Results were  not  that  significant  for  high  quality  surveys
(P=0.08). The author concludes that further high quality studies are needed to confirm results.
Cucherat, M., Haugh, M. C., Gooch, M., & Boissel,  J. P.  2000,  "Evidence  of  clinical  efficacy  of
homeopathy. A meta-analysis of clinical trials. HMRAG. Homeopathic Medicines Research Advisory
Group", Eur.J.Clin.Pharmacol., vol.. 56, no. 1, pp. 27-33.

A systematic review of results from 93 substantive RCTs was carried out by Robert Mathie (2003). It
concludes  that of  the 35 different medical conditions covered by  these  trials  the weight of evidence
favours a positive  treatment effect  in 8: childhood diarrhoea, fibrositosis, hay fever,  influenza, pain
(miscellaneous),  side-effects  of  chemotherapy  or  radiotherapy,  sprains  and  upper-respiratory  tract
infections.
Mathie,  R.  The  research  evidence  base  for  homeopathy:  a  fresh  assessment  of  the  literature.
Homeopathy 92: 84-91. 2003.

Meta-analysis of 89 trials of homeopathic medicine versus placebo. Result: significantly in favour of
homeopathy  (OR  2,45  (95% CI  2,05-2,93)).  This meta-analysis  included  186  placebo-controlled
studies of homeopathy published until mid-1996, of which data for analysis could be extracted from
89. The overall odds ratio was 2.45 (95% confidence  intervals 2.05-2.93)  in favour of homeopathy,
which means that the chances that homeopathy would benefit the patient were 2.45 times greater than
placebo. When considering just those trials of high quality published in MEDLINE listed journals, and
with predefined primary outcome measures, the pooled odds ratio was 1.97 and significant. Even after
correction  for publication bias  the  results  remained  significant. The main  conclusion was  that  the results "were not compatible with the hypothesis that the effects of homeopathy are completely due to
placebo". If the result of new trials were to show no difference between homeopathy and placebo, we
would have to add 923 trials with no effect with 118 patients in each in order to balance the two.
Linde K, Clausius N, Ramirez G, et al. Are  the clinical effects of homoeopathy placebo effects? A
meta-analysis of placebo-controlled trials. Lancet 1997;350:834-43

HMRG  report with overview of clinical  research  in homeopathy,  identified 184 controlled clinical
trials. They  selected  the highest quality  randomized  control  trials, which  included  a  total of 2617
patients for a meta-analysis. This meta-analysis resulted in a p-value of 0.000036 (which means that
results  are  highly  significant)  indicating  that  homeopathy  is  more  effective  than  placebo.  The
researchers  concluded  that  the  "hypothesis  that  homeopathy  has  no  effect  can  be  rejected with
certainty". Homeopathic Medicine Research Group.
Report to the European Commission directorate general XII: science, research and development. Vol
1 (short version). Brussels: European Commission, 1996:16-7.

Of  the 105  trials with  interpretable results, 81  trials  indicated positive results. Most studies showed
results  in  favour of homeopathy even among  those  randomized controlled  trials  that  received high-
quality ratings for randomization, blinding, sample size, and other methodological criteria. They came
to the following conclusion: "The amount of positive evidence even among the best studies came as a
surprise to us. Based on this evidence we would readily accept that homeopathy can be efficacious, if
only  the mechanism  of  action were more  plausible. The  evidence  presented  in  this  review would
probably be sufficient for establishing homeopathy as a regular treatment for certain indications".
Kleijnen  J,  Knipschild  P,  Ter  Riet G.  Clinical  trials  of  homoeopathy.  British Medical  Journal.
1991b;302:316-23.

A health  technology  assessment  report on  effectiveness,  cost-effectiveness  and  appropriateness of
homeopathy was compiled on behalf of the Swiss Federal Office for Public Health. Results showed a
positive overall result in favour of homeopathy in 29 studies on upper respiratory tract infections and
allergic reactions. Results also showed many high-quality investigations of pre-clinical basic research
proved  homeopathic  high-potencies  inducing  regulative  and  specific  changes  in  cells  or  living
organisms. 20 of 22 systematic reviews detected at least a trend in favour of homeopathy.
Boarnhoft G, Wolf U, Ammon K, Righetti M, Maxion-Bergemann S, Baumgartner S, Thurneysen AE,
Matthiessen PF. Effectiveness,  safety  and  cost-effectiveness  of  homeopathy  in  general  practice  –
summarized health technology assessment. Forsch Komplementarmed. 2006; 13 Suppl 2: 19-29.

A meta-analysis of three trials on homeopathic immunotherapy.
Result: significant effect in favour of homeopathic treatment.
Reilly D, Taylor MA, Beattie NGM, Campbell JH, McSharry C, Aitchison TC, Carter R, Stevenson
RD. Is evidence for homoeopathy reproducible? Lancet. 1994;344:1601-1606.

A review of placebo-controlled clinical trials using homeopathic medicines to treat people with AIDS
or who  are HIV-positive  found 5  controlled  clinical  trials. Results  showed  statistically  significant
results in subjects with stage III AIDS, and specific physical, immunologic, neurologic, metabolic, and
quality-of-life benefits, including improvements in lymphocyte counts and functions and reductions in
HIV viral loads in patients receiving homeopathic treatment.
Ullman D. Controlled Clinical Trials Evaluating the Homeopathic Treatment of People with Human
Immunodeficiency Virus or Acquired Immune Deficiency Syndrome. The Journal of Alternative and
Complementary Medicine. Volume 9, Number 1, 2003, pp. 133-141.

Meta-analysis of 105 articles on laboratory research.
Result: positive effect 50% more frequently than negative effect among trials of highest methodological quality. (1994)
Linde K. Jonas WB, Melchart D, Worku F, Wagner H, Eital F. Critical Review and Meta-Analysis of
Serial  Agitated  Dilutions  in  Experimental  Toxicology.  Human  and  Experimental  Toxicology.
1994;13:481-492