* Corresponding Author; What Is the Best Available Evidence for Using Homeopathy in Patients with Intellectual Disabilities? (original) (raw)
Related papers
What is the best available evidence for using homeopathy in patients with intellectual disabilities?
Iranian journal of pediatrics, 2014
The debate about the effectiveness of homeopathy hits the headlines from time to time. Reported evidences for the role of homeopathy in psychiatric illness relevant to people with intellectual disabilities are patchy and inconsistent. In this review we summarize the best available evidence for the use of homeopathy to treat the psychiatric disorders common in this population. Systematic literature review was conducted through February 2012 to July 2012 in AMED, CINHAL, BNI, EMBASE, MEDLINE, PSYCHINFO and GOOGLE SCHOLAR. In the next steps thirty eight homeopathic associations were contacted and a top-up literature search was done on Scopus and World of Science databases till March 2014. Twelve relevant clinical trials were identified and included in this study. The quality of each trial was assessed by the Oxford quality scoring system (Known as Jadad score) as well as subjective review by two reviewers independently (good versus poor). Findings : The largest body of evidence pertain...
2014
Objective: The debate about the effectiveness of homeopathy hits the headlines from time to time. Reported evidences for the role of homeopathy in psychiatric illness relevant to people with intellectual disabilities are patchy and inconsistent. In this review we summarize the best available evidence for the use of homeopathy to treat the psychiatric disorders common in this population. Methods: Systematic literature review was conducted through February 2012 to July 2012 in AMED, CINHAL, BNI, EMBASE, MEDLINE, PSYCHINFO and GOOGLE SCHOLAR. In the next steps thirty eight homeopathic associations were contacted and a top-up literature search was done on Scopus and World of Science databases till March 2014. Twelve relevant clinical trials were identified and included in this study. The quality of each trial was assessed by the Oxford quality scoring system (Known as Jadad score) as well as subjective review by two reviewers independently (good versus poor). Findings: The largest body of evidence pertained to the use of homeopathy in the treatment of attention deficit hyperactivity disorder (ADHD). There is heterogeneity in the quality of trials and also the outcome of studies but overall our findings suggest some potential for using homeopathy in ADHD. Current evidences do not support the use of homeopathy for treatment of speech and language difficulties. There was only one trial concerning the use of homeopathy in Autistic Spectrum Disorder. This was of a poor quality and unable to provide any recommendation. Conclusion: Whilst acknowledging the risk of publication and language bias in our study, the currently available evidences are neither conclusive nor comprehensive enough to give us a clear picture for the use of homeopathy in patients with intellectual disabilities. There are large gaps in the body of evidence concerning the role of homeopathy in the treatment of common disorders in intellectual disability, such as autism, challenging behavior or developmental arrest in childhood.
2016
The current state of homeopathic research This report on the current state of homeopathic research provides a summary on the research areas of healthcare research, randomised controlled clinical trials, meta-analyses and basic research. It aims to contribute to the discussion within the field of homeopathy concerning the need for research, the relevance of individual research fields and methods, and their role in future research strategies. We are also publishing this report on the current status of scientific research, moreover, for the benefit of medical science as a whole and the public. Whilst the conventional development of medicinal products is based on research which must then stand up to medical practice, homeopathy is primarily a successful medical practice that must stand up to scientific research. Outcome studies investigating homeopathic treatment under routine conditions have reported clinically relevant improvements in symptoms and quality of life, often comparable with those under conventional treatments, but with fewer adverse effects. In half of all health economic evaluations homeopathic treatment showed less costs. Methodologically, a causal relationship between drug therapy and therapeutic outcome cannot be deduced from those studies. The randomised controlled clinical trials investigated here, studies with good methodology into individualised homeopathy with high potencies only, have indicated, like earlier studies, that classical homeopathy is superior to placebo, and that remedies in high potencies have a specific effect. A definitive scientific statement cannot be made at present given the heterogeneous nature of the data and the small number of studies of good quality. A review of the meta-analyses of homeopathy reveals results which mostly are statistically significant compared to placebo, suggesting specific efficacy from potentised remedies. Depending on the selection criteria applied, different studies are thereby included in the analysis. The majority of the studies reported in all the examined reviews (also Shang et al.), including those with good methodology, suggest that homeopathic treatment is superior to placebo. These findings are in part markedly qualified by the authors of the respective meta-analyses in their (comment/discussion and) conclusion. The stated caveats, e.g. with respect to study quality, thereby do not always reflect the usual scientific standards, or they actually refer explicitly to the postulated implausibility of the efficacy of high-potency medicines. There are a number of high-quality basic research studies that report specific effects also for high potencies, inclusive also of independently replicated experimental models. There are initial empirical results pointing to the physicochemical and pharmaceutical, as well as biological ways homeopathic remedies work, but no theory is fully developed yet. A summary analysis of the clinical research data offers sufficient evidence of the therapeutic effectiveness of homeopathic treatment. The results from numerous placebo-controlled trials and basic research experiments suggest, moreover, that potentised medicines offer a specific efficacy.
Trials, 2017
Background: Despite controversy regarding homeopathy, some patients consult homeopaths for depression. Evidence is required to determine whether this is an effective, acceptable and safe intervention for these patients. Methods: A pragmatic trial using the "cohort multiple randomised controlled trial" design was used to test the effectiveness of adjunctive treatment by homeopaths compared to usual care alone, over a period of 12 months in patients with self-reported depression. One third of patients were randomly selected for an offer of treatment provided by a homeopath. The primary outcome measure was the Patient Health Questionnaire (PHQ-9) at 6 months. Secondary outcomes included depression scores at 12 months; and the Generalised Anxiety Disorder (GAD-7) outcome at 6 and 12 months. Results: The trial over-recruited by 17% with a total of 566 patients. Forty percent took up the offer and received treatment. An intention-to-treat analysis of the offer group at 6 months reported a 1.4-point lower mean depression score than the no offer group (95% CI 0.2, 2.5, p = 0.019), with a small standardized treatment effect size (d = 0.30). Using instrumental variables analysis, a moderate treatment effect size in favour of those treated was found (d = 0.57) with a between group difference of 2.6 points (95% CI 0.5, 4.7, p = 0.018). Results were maintained at 12 months. Secondary analyses showed similar results. Similar results were found for anxiety (GAD-7). No evidence suggested any important risk involved with the intervention. Conclusion: This trial provides preliminary support for both the acceptability and the effectiveness of treatment by a homeopath for patients with self-reported depression. Our results provide support for further pragmatic research to provide more precise estimates of treatment effect.
Systematic Reviews
Background: A rigorous systematic review and meta-analysis focused on randomised controlled trials (RCTs) of nonindividualised 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 prepublished 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 subgroup 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.
A systematic review of the quality of homeopathic clinical trials
BMC complementary and alternative medicine, 2001
While a number of reviews of homeopathic clinical trials have been done, all have used methods dependent on allopathic diagnostic classifications foreign to homeopathic practice. In addition, no review has used established and validated quality criteria allowing direct comparison of the allopathic and homeopathic literature. In a systematic review, we compared the quality of clinical-trial research in homeopathy to a sample of research on conventional therapies using a validated and system-neutral approach. All clinical trials on homeopathic treatments with parallel treatment groups published between 1945-1995 in English were selected. All were evaluated with an established set of 33 validity criteria previously validated on a broad range of health interventions across differing medical systems. Criteria covered statistical conclusion, internal, construct and external validity. Reliability of criteria application is greater than 0.95. 59 studies met the inclusion criteria. Of these,...
A systematic review of systematic reviews of homeopathy
British Journal of Clinical Pharmacology, 2002
Homeopathy remains one of the most controversial subjects in therapeutics. This article is an attempt to clarify its effectiveness based on recent systematic reviews. Electronic databases were searched for systematic reviews/meta-analysis on the subject. Seventeen articles fulfilled the inclusion/exclusion criteria. Six of them related to re-analyses of one landmark meta-analysis. Collectively they implied that the overall positive result of this meta-analysis is not supported by a critical analysis of the data. Eleven independent systematic reviews were located. Collectively they failed to provide strong evidence in favour of homeopathy. In particular, there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. Similarly, there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo. It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice.
A new programme of systematic reviews of randomised controlled trials (RCTs) in homeopathy will distinguish important attributes of RCT records, including: placebo controlled versus other-than-placebo (OTP) controlled; individualised versus non-individualised homeopathy; peer-reviewed (PR) versus non peer-reviewed (NPR) sources. Aims: (a) To outline the methods used to search and categorise the RCT literature; (b) to report details of the records retrieved; (c) to compare our retrieved records with those reported in two previous systematic reviews . Methods: Ten major electronic databases were searched for records published up to the end of 2011. A record was accepted for subsequent systematic review if it was a substantive report of a clinical trial of homeopathic treatment or prophylaxis in humans, randomised and controlled, and published in a PR or NPR journal. Results: 489 records were potentially eligible: 226 were rejected as non-journal, minor or repeat publications, or lacking randomisation and/or controls and/or a 'homeopathic' intervention; 263 (164 PR, 99 NPR) were acceptable for systematic review. The 263 accepted records comprised 217 (137 PR, 80 NPR) placebo-controlled RCTs, of which 121 were included by, 66 were published after, and 30 were potentially eligible for, but not listed by, Linde or Shang. The 137 PR records of placebo-controlled RCTs comprise 41 on individualised homeopathy and 96 on non-individualised homeopathy. Conclusion: Our findings clarify the RCT literature in homeopathy. The 263 accepted journal papers will be the basis for our forthcoming programme of systematic reviews. Homeopathy (2013) 102, 3e24.
Homeopathic Management of Autism Spectrum Disorder: Illustrative Cases
Abstract: Autism is a Pervasive Developmental Disorder that has an impact on communication, sensory processing, cognition and behaviour of the child. It is quite a serious and complex disorder. This article comprises of two illustrative cases seen at Spandan Holistic Institute of Applied Homoeopathy, Mumbai, a Holistic Multidisciplinary Institute, where 123 autistic children were treated including 60 cases under AYUSH-Central Council of Research in Homeopathy sponsored Extra Mural Research project on Autism