Research Randomised placebo-controlled trials of individualised homeopathic treatment: systematic review and meta-analysis Robert T Mathie1*, Suzanne M Lloyd2, Lynn A Legg3, Jürgen Clausen4, Sian Moss5, Jonathan RT Davidson6 and Ian Ford2
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Research
Randomised placebo-controlled trials of individualised homeopathic treatment: systematic review and meta-analysis
1 British Homeopathic Association, Luton, UK
2 Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
3 Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
4 Karl und Veronica Carstens-Stiftung, Essen, Germany
5 Homeopathy Research Institute, London, UK
6 Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
Systematic Reviews 2014, 3:142 doi:10.1186/2046-4053-3-142
The electronic version of this article is the complete one and can be found online at: http://www.systematicreviewsjournal.com/content/3/1/142
Received: 26 June 2014 Accepted: 12 November 2014 Published: 6 December 2014 © 2014 Mathie et al.; licensee BioMed Central.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Abstract
Background
A rigorous and focused systematic review and meta-analysis of randomised controlled trials (RCTs) of individualised homeopathic treatment has not previously been undertaken. We tested the hypothesis that the outcome of an individualised homeopathic treatment approach using homeopathic medicines is distinguishable from that of placebos.
Methods
The review’s methods, including literature search strategy, data extraction, assessment of risk of bias and statistical analysis, were strictly protocol-based. Judgment in seven assessment domains enabled a trial’s risk of bias to be designated as low, unclear or high. A trial was judged to comprise ‘reliable evidence’ if its risk of bias was low or was unclear in one specified domain. ‘Effect size’ was reported as odds ratio (OR), with arithmetic transformation for continuous data carried out as required; OR > 1 signified an effect favouring homeopathy.
Results
Thirty-two eligible RCTs studied 24 different medical conditions in total. Twelve trials were classed ‘uncertain risk of bias’, three of which displayed relatively minor uncertainty and were designated reliable evidence; 20 trials were classed ‘high risk of bias’. Twenty-two trials had extractable data and were subjected to meta-analysis; OR = 1.53 (95% confidence interval (CI) 1.22 to 1.91). For the three trials with reliable evidence, sensitivity analysis revealed OR = 1.98 (95% CI 1.16 to 3.38).
Conclusions
Medicines prescribed in individualised homeopathy may have small, specific treatment effects. Findings are consistent with sub-group data available in a previous ‘global’ systematic review. The low or unclear overall quality of the evidence prompts caution in interpreting the findings. New high-quality RCT research is necessary to enable more decisive interpretation.
Keywords:
Individualised homeopathy; Meta-analysis; Randomised controlled trials; Systematic review
http://www.systematicreviewsjournal.com/content/3/1/142
