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

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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 Science of Homeopathy Theories Understanding

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 CAM model Practice Mechanism Safety Trials of efficacy Effectiveness Effectiveness in practise Efficacy of components Safety Mechanism of action Adapted from Fonnebo etal BMC Med Res Meth (7) 7

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

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 *Quality assessed using SAPEH scores, high-quality > 6 Review: C Witt etal J Alt Comp Med :1,

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,

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

15 Human provings A successful example Average number of Symptoms Arsenicum specific symptoms Nat-mur specific symptoms Non-specific symptoms Arsenicum group Nat-mur group Associated p = Placebo group Adapted from H. Möllinger Homeopathic Drug Provings between historical and scientific demand LMHI 2008

16 Meta-analyses Kleijnen etal 1991 Boissel etal 1996 Linde etal 1997* Linde & Melchart 1998* Cucherat etal 2000* Shang etal studies 15 Hi-Qt studies 89 studies 32 Hi-Qt studies 16 Hi-Qt studies 8 (110) studies (?) *Included in UK DARE (Database of Abstracts of Reviews of Effects)

17 Shang etal 2005 Meta-analysis 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)

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 sciences (one systematic review) Molecular and cellular (one systematic review) Animals IIa+ IIa+ IIIa / IIb

20 Levels of evidence for human trials I I IIa IIb Overall (3/3 Hi-Qt meta-analyses) Allergic rhinitis, post-operative ileus, rheumatoid arthritis, protection from toxic substances Asthma, fibrosis, influenza, muscular pain, otitis media, strains ENT infections, side effect radiotherapy Anxiety, ADHD, IBS, migraine, osteo-arthritis, PMS, Post-tonsillectiomy analgesia, nausea during chemotherapy, septicaemia Michel van Wassenhofen, ECH publication LMHI 2008

21 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

22 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

23 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

24 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

25 Thank you For more information:

WHY HOMEOPATHY SHOULD CONTINUE TO BE ROUTINELY PRESCRIBED IN PRIMARY CARE

WHY HOMEOPATHY SHOULD CONTINUE TO BE ROUTINELY PRESCRIBED IN PRIMARY CARE The Society of Homeopaths is the UK s largest group of registered professional Homeopaths. We promote the highest professional