Confessions of a Quackbuster

This blog deals with healthcare consumer protection, and is therefore about quackery, healthfraud, chiropractic, and other forms of so-Called "Alternative" Medicine (sCAM).

Friday, August 26, 2005

Any Homeopathy Benefit Attributed to Placebo Effect

Any Homeopathy Benefit Attributed to Placebo Effect

By Peggy Peck, Senior Editor, MedPage Today
August 25, 2005

BERNE, Switzerland. Aug. 25-Orthodox medicine is cutting no slack with homeopathy. A meta-analysis found that any benefits claimed by smaller and smaller doses of homeopathic medicine vanish into the never-never land of the placebo effect.

The meta-analysis of findings from 110 homeopathy trials and 110 matched conventional-medicine trials found that the benefits claimed by homeopathy can be explained by placebo effect, according to results reported in the Aug. 27 issue of The Lancet.

The researchers, led by Aijing Shang, Ph.D., of the University of Berne, said that previous reports that homoeopathic treatments were as effective as conventional or allopathic medicine were due to biases present in both homoeopathic and allopathic trials.

But when the biases are stripped away, there is still strong evidence of benefit for conventional treatments but "there was no convincing evidence that homeopathy was superior to placebo."

This finding was hammered home by an editorial, a commentary, and a news report detailing controversy surrounding a World Health Organization draft report on homeopathy.

The Swiss group analyzed data from controlled trials of treatments or preventive measures with clinical outcomes. All studies were randomized with a parallel-group design and placebo controls and all were described in written reports but not all studies were published. All studies had sufficient data to allow calculation of odds ratios.

For studies in which no main outcome measure was defined, the authors selected outcomes from a pre-determined list: patients' overall assessment of improvement; physicians' assessment of improvement; or the most clinically relevant outcome.

Clinical topics in the trials included respiratory infections, surgery and anesthesiology. Fifty-eight percent of the homeopathy trials and 85% of the conventional medical trials were published in English-language journals.

The Lancet editorial concluded that based on the evidence doctors should be "bold and honest with their patients about homeopathy's lack of benefit, and with themselves about the failings of modern medicine to address patients' needs for personalized care."

In the commentary, Jan P. Vandenbroucke, M.D., Ph.D., of Leiden University Medical Center in The Netherlands wrote that "Shang and colleagues arrive at a class judgment about homeopathy that will be gladly accepted by many who always thought homoeopathic evidence was contaminated. Others will claim this analysis amounts to 'data dredging.'"

But, he added that allopathic medicine provides the ultimate proof of efficacy, "by preventing, alleviating, and curing disease ever more effectively."

Meanwhile, Michael McCarthy in a news analysis reported that WHO has issued a draft report favorable to homeopathy that skeptics are calling "little more than pro-homeopathy propaganda," This suggests that the conventional medicine versus homeopathy battle is far from over.

Related Information:

* Tell patients that the results of this study suggest that homeopathy is not as effective as conventional medicine.

* Caution patients about the use of alternative or non-conventional treatments that are not evidence-based.

Primary source: The Lancet
Source reference:
Shang A et al "Are the clinical effects of homeopathy placebo effects? Comparative study of placebo-controlled trials of homeopathy and allopathy." Lancet 2005;366:726-731;
"The end of homeopathy" Lancet 2005;366:690;
Vandenbroucke JP ""Homeoapthy and the 'growth of truth'" Lancet 2005;366:691-692;
McCarthy M "Critics slam draft WHO report on homeopathy." Lancet 2005;366:705-704

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