Randomised, double-blind, placebo-controlled trials of non-individualised homeopathic treatment: systematic review and meta-analysis.
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2017-03
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Abstract
Background
A rigorous systematic review and meta-analysis focused on randomised controlled trials (RCTs) of non-individualised homeopathic treatment has not previously been reported. We tested the null hypothesis that the main outcome of treatment using a non-individualised (standardised) homeopathic medicine is indistinguishable from that of placebo. An additional aim was to quantify any condition-specific effects of non-individualised homeopathic treatment.Methods
Literature search strategy, data extraction and statistical analysis all followed the methods described in a pre-published protocol. A trial comprised 'reliable evidence' if its risk of bias was low or it was unclear in one specified domain of assessment. 'Effect size' was reported as standardised mean difference (SMD), with arithmetic transformation for dichotomous data carried out as required; a negative SMD indicated an effect favouring homeopathy.Results
Forty-eight different clinical conditions were represented in 75 eligible RCTs. Forty-nine trials were classed as 'high risk of bias' and 23 as 'uncertain risk of bias'; the remaining three, clinically heterogeneous, trials displayed sufficiently low risk of bias to be designated reliable evidence. Fifty-four trials had extractable data: pooled SMD was -0.33 (95% confidence interval (CI) -0.44, -0.21), which was attenuated to -0.16 (95% CI -0.31, -0.02) after adjustment for publication bias. The three trials with reliable evidence yielded a non-significant pooled SMD: -0.18 (95% CI -0.46, 0.09). There was no single clinical condition for which meta-analysis included reliable evidence.Conclusions
The quality of the body of evidence is low. A meta-analysis of all extractable data leads to rejection of our null hypothesis, but analysis of a small sub-group of reliable evidence does not support that rejection. Reliable evidence is lacking in condition-specific meta-analyses, precluding relevant conclusions. Better designed and more rigorous RCTs are needed in order to develop an evidence base that can decisively provide reliable effect estimates of non-individualised homeopathic treatment.Type
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Mathie, Robert T, Nitish Ramparsad, Lynn A Legg, Jürgen Clausen, Sian Moss, Jonathan RT Davidson, Claudia-Martina Messow, Alex McConnachie, et al. (2017). Randomised, double-blind, placebo-controlled trials of non-individualised homeopathic treatment: systematic review and meta-analysis. Systematic reviews, 6(1). p. 63. 10.1186/s13643-017-0445-3 Retrieved from https://hdl.handle.net/10161/25995.
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Jonathan R.T. Davidson
Currently, my research focuses upon the theoretical aspects of homeopathy and its clinical utilization, as well as the broader field of alternative (complementary) medicine. this is a field which has traditionally been overlooked as a legitimate scientific discipline. Other areas of activity are as in the past, i.e., clinical treatment, epidemiology, risk factors, pathogenesis of posttraumatic stress, social phobia, other anxiety status, and depression. These are illustrated by recent publications on treatment, epidemiology, health service utilization and quality of life in social phobia and PTSD, drug treatment of panic disorder. Magnetic resonance studies of social phobia have been completed and further studies are planned.
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