Abstract
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. Put in perspective, there are many important open research areas – notably: • Basic research into the optimisation of laboratory models and the understanding of the mode of action • Independent replications of studies in clinical and basic research • Exploration of the provision of homeopathic care in reality, also combined with conventional medicine • Health economic analyses to evaluate the costs and benefits (cost effectiveness)
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