Homeopathy & Evidence Based Medicine
non-scientific interests consequently lead to misinformation about homeopathy
When inconvenient research emerges, manipulative tactics which manufacture doubt and create uncertainty are implemented to influence, stifle and silence independent science to better serve corporate interests (1), corrupting the premise and practice of evidence based medicine (EBM) (2).
Perfectly illustrative of this gross process is the Gartlehner et al., (3) conclusion that outcome reporting bias (ORB) in homeopathy ‘affects the validity of the body of evidence of homeopathic literature and may overestimate the true treatment effect.’ This meta-analysis literally breezed past the fact that ORB affects all disciplines of medical research and is prevalent in Randomized Controlled Trials (RCT) (4), Systematic reviews, and Cochrane protocols (5-7), and failed to mention that their finding of ORB in 25% of published homeopathy trials is almost equal to the 23% ORB found in Cochrane systematic review groups (5). The Homeopathy Research Institute (8) noted this study actually showed that in regard to scientific and ethical standards ‘homeopathy is out-performing conventional medicine in this respect, with lower levels of reporting bias.’
Prior to 2014, five of six meta-analyses concluded homeopathy differs from placebo.(9-13) One systematic review with meta-analysis,(14) the second Australian NHMRC Report(15) - the first (2012) found encouraging evidence for the effectiveness of homeopathy in five medical conditions and remained undisclosed until its existence was uncovered and the resulting and sustained international outcry ensured its release in 2019,(16) and the EASAC Statement(17) where more than 90% of the studies were excluded from analysis, did not show any effectiveness of homeopathy beyond placebo - interestingly, a 2013 review confirmed that more than 90% of studies must be excluded to be able to find homeopathy ineffective(18).
As individualized homeopathy especially demonstrates effects at all quality levels according to Cochrane criteria, even in the methodologically high-quality studies, an obvious conclusion is that non-scientific interests consequently lead to misinformation about homeopathy,(19) Weiermayer et al.,(20) cite and rebut the recent A Systematic Review of Complementary and Alternative Veterinary Medicine: “Miscellaneous Therapies”(21) as a case in point.
Debasement of medical research integrity is not a new phenomenon, former editors of The New England Journal of Medicine and the British Medical Journal have published books on the subject (22-24). Much of today’s EBM is said to be questionable (25) with a Stanford study revealing just 7% of 60,000 clinical studies were of high quality and clinically relevant to patients (26).
Thanks for reading Evidence Based Complementary Medicine. To receive new posts and support my work, please consider becoming a free or paid subscriber. Thank you!
Sarah Penrose BSc(hons)Hom. is an Australasian homeopath and can be contacted at goodhealthforgreatlife.com
1 Reed et al., 2021. The disinformation playbook: how industry manipulates the science-policy process-and how to restore scientific integrity. Journal of Public Health Policy. Dec;42(4):622-634. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8651604/
2 Jureidini & McHenry, 2022. The illusion of evidence based medicine. British Medical Journal (Clinical research edition). Mar 16;376:o702. Available from https://www.bmj.com/content/376/bmj.o702.long
3 Gartlehner et al., 2022. Assessing the magnitude of reporting bias in trials of homeopathy: a cross-sectional study and meta-analysis. British Medical Journal; Evidence Based Medicine. Mar 15:bmjebm-2021-111846. Available from https://ebm.bmj.com/content/early/2022/05/08/bmjebm-2021-111846.long
4 Dwan et al., 2008. Systematic review of the empirical evidence of study publication bias and outcome reporting bias. PLoS One. Aug 28;3(8):e3081. Available from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0003081
5 Shah et al., 2020. Outcome reporting bias in Cochrane systematic reviews: a cross-sectional analysis. British Medical Journal open. Mar 16;10(3):e032497. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7076244/
6 Kirkham et al., 2010. The impact of outcome reporting bias in randomised controlled trials on a cohort of systematic reviews. British Medical Journal. Feb 15;340:c365. Available from: https://www.bmj.com/content/340/bmj.c365.long
7 Kirkham et al., 2010. Bias due to changes in specified outcomes during the systematic review process. PLoS One. Mar 22;5(3):e9810. Available from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0009810
8 Homeopathy Research Institute (HRI). 2022. HRI comment on BMJ article assessing reporting bias in trials of homeopathy. Kensington, London. Available from https://www.hri-research.org/2022/03/homeopathy-research-institute-hri-comment-on-bmj-article-assessing-reporting-bias-in-trials-of-homeopathy/
9 Kleijnen, J., Knipschild, P., Ter Riet, G. (1991): Clinical trials of homeopathy. BMJ 302(6772): 316-23. Available from https://pubmed.ncbi.nlm.nih.gov/1827743/
10 Linde et al., 1997. Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet 350(9081): 834–843. https://pubmed.ncbi.nlm.nih.gov/9310601/
11 Linde et al, 1999. Impact of study quality on outcome in placebo-controlled trials of homeopathy. J Clin Epidemiol 52(7): 631–636. https://pubmed.ncbi.nlm.nih.gov/10391656/
12 Cucherat et al., 2000. Evidence of clinical efficacy of homeopathy. A meta-analysis of clinical trials. HMRAG. Homeopathic Medicines Research Advisory Group. Eur J Clin Pharmacol 56(1): 27–33. https://pubmed.ncbi.nlm.nih.gov/10853874/
13 Mathie et al., 2014. Randomised placebo-controlled trials of individualised homeopathic treatment: systematic review and meta-analysis. Syst Rev 3: 142. https://pubmed.ncbi.nlm.nih.gov/25480654/
14 Shang et al., 2005. Are the clinical effects of homeopathy placebo effects? Comparative study of placebo-controlled trials of homeopathy and allopathy. Lancet 366(9487): 726–32. https://pubmed.ncbi.nlm.nih.gov/16125589/
15 NHMRC Information Paper, Evidence on the effectiveness of homeopathy for treating health conditions. 2015. Australian Government National Health and Medical Research Council. Canberra, Australia. https://www.nhmrc.gov.au/about-us/resources/homeopathy
16 Homeopathy Research Institute. 2021. The Australian Report. Kensington, London. Available from https://www.hri-research.org/resources/homeopathy-the-debate/the-australian-report-on-homeopathy
17 European Academies Science Advisory Council. Homeopathic products and practices: assessing the evidence and ensuring consistency in regulating medical claims in the EU, 2017. Halle, Deutschland. (letzter Zugriff 20.7.2020).
18 Hahn, 2013. Homeopathy: meta-Analysis of pooled clinical data. Forsch Komplement 20(5): 376–81. Available from https://pubmed.ncbi.nlm.nih.gov/24200828/
19 Matthiessen, 2018. Homöopathie und intellektuelle Redlichkeit – Eine Stellungnahme. Dtsch Zeitschrift für Onkol 50: 172. Available from https://www.homoeopathie-heute.de/aktuelles-archiv/2019/homoeopathie-und-intellektuelle-redlichkeit-eine-stellungnahme/
20 Weiermayer et al., 2022. Evidence-Based Human Homeopathy and Veterinary Homeopathy. Comment on Bergh et al. A Systematic Review of Complementary and Alternative Veterinary Medicine: "Miscellaneous Therapies." Animals (Basel). 11, 3356. Animals (Basel). Aug 17;12(16):2097. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9404715/
21 Bergh et al., 2021. A Systematic Review of Complementary and Alternative Veterinary Medicine: "Miscellaneous Therapies". Animals (Basel). Nov 24;11(12):3356. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8697896/
22 Angell, M. 2005. The Truth About the Drug Companies: How They Deceive Us and What to Do About It. Random House Trade Paperbacks.
23 Kassirer, J. 2005. On the Take: How Medicine's Complicity with Big Business Can Endanger Your Health. Oxford University Press.
24 Smith, R. 2006. The Trouble with Medical Journals. Routledge.
25 Heneghan et al., 2017. Evidence based medicine manifesto for better healthcare. British Medical Journal. Jun 20;357:j2973. Available from https://www.bmj.com/content/357/bmj.j2973
26 Ioannidis et al., 2017. How to survive the medical misinformation mess. European Journal of Clinical Investigation. Nov;47(11):795-802. Available from https://onlinelibrary.wiley.com/doi/full/10.1111/eci.12834