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Overview of the current state of the research in Homeopathy Dr Alexander Tournier BSc Cantab PhD LCHE RSHom.

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Presentation on theme: "Overview of the current state of the research in Homeopathy Dr Alexander Tournier BSc Cantab PhD LCHE RSHom."— Presentation transcript:

1 Overview of the current state of the research in Homeopathy Dr Alexander Tournier BSc Cantab PhD LCHE RSHom

2 Aims To show that science and homeopathy are indeed compatible To present evidence coming from different fields of science To present Homeopathy Research Institute

3 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

4 Scientific discovery process Observation Experimentation Theories Understanding Science of Homeopathy

5 Unscientific argumentation “Homeopathy does not work … … because it cannot work” is not scientific, as it is not grounded in observation

6 Science of homeopathy Hahnemann built homeopathy following a rigorous scientific approach: Experimentation ◦ Provings ◦ Clinical experience Theories and concepts ◦ Law of similars ◦ Principle of dilution ◦ Concept of the vital force

7 Different scientific approaches Pharmaceutical model Screening Mechanism Trials of efficacy Effectiveness in practise Safety CAM model Practice Safety Effectiveness Efficacy of components Mechanism of action Adapted from Fonnebo etal BMC Med Res Meth 2007 11(7) 7

8 Homeopathy: a new science Adhami H.R., S.Shamloo D., Mesgarpour B., H.Tehrani S.A. “The trend of homeopathic articles indexed in pubmed and ISI” LMHI 2008 Number of scientific publications over the last 20 year

9 Scientific evidence in Homeopathy Materials sciences Molecular and cellular systems Animal studies Human studies

10 Evidence from Material Sciences NMR evidence (5/5 Hi-Qt* pub) Low temp thermoluminescence  Raman and UV-Vis Spectroscopy  Dielectric strength  Review: C Witt etal J Alt Comp Med 2003 9:1, 113-32 *Quality assessed using SAPEH scores, high-quality > 6

11 Molecular and cellular systems Enzymatic reactions (7/9 Hi-Qt* pub) Cultured cells (5/9 Hi-Qt pub) Basophil degranulation (8/11 Hi-Qt pub) *Quality assessed using SAPEH scores, high-quality > 6 C Witt etal Comp Ther Med, 2007 15 128-38

12 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 

13 Human trials 134 RCT have been published ◦ 59 (44%) positive ◦ 67 (50%)neutral (small effect) ◦ 8 (6%) negative 23 systematic reviews ◦ 10 positive ◦ 8 non-conclusive ◦ 5 little or no evidence P. Fisher ‘Research in Homoeopathy: Who needs it’ LMHI 2008

14 Only one review up to 1995  More recent trials are of higher quality Need a review of the recent provings Need more trials Human provings or Human pathogenetic trials

15 Human provings A successful example Adapted from H. Möllinger ‘Homeopathic Drug Provings between historical and scientific demand’ LMHI 2008 Associated p = 0.0002

16 Meta-analyses Kleijnen etal 1991 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 + Shang etal 2005 8 (110) studies - ( + ? ) *Included in UK DARE (Database of Abstracts of Reviews of Effects)

17 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) Shang etal 2005 Meta-analysis

18 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

19 Levels of evidence Material sciencesIIa+ (one systematic review) Molecular and cellular IIa+ (one systematic review) Animals IIIa / IIb

20 Levels of evidence for human trials IOverall (Meta analyses 5/6) I Allergic rhinitis, post-operative ileus, rheumatoid arthritis, protection from toxic substances IIa Asthma, fibrosis, influenza, muscular pain, otitis media, strains ENT infections, side effect radiotherapy IIb Anxiety, ADHD, IBS, migraine, osteo-arthritis, PMS, Post-tonsillectiomy analgesia, nausea during chemotherapy, septicaemia Michel van Wassenhofen, ECH publication LMHI 2008

21 Problems with RCTs DBRCT are currently the gold standard of medical research However, they are not well adapted to research in complementary medicine Not in line with standard practice Comparative trials

22 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

23 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

24 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

25 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

26 Thank you For more information:

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