Parkinson's: screen for osteoporosis
Recent reports of the death of homoeopathy in The Lancet were exaggerated. Readers who like to think about the evidence may be interested to know the Lancet study is the sixth systematic review of homoeopathy published, and only the second to show a definite negative result.
That negative result is very questionable, however. It is based on only eight studies of homoeopathy (not 110 studies as claimed by the authors) compared with six studies in conventional care. These eight studies were the largest, but were also poorly blinded. The original sample of 110 studies showed therapeutic effect comparable with that in the 110 conventional trials.
Perhaps the authors were among those who feel that because of the high attenuations of ultramolecular dilutions homoeopathy cannot work, and therefore does not, whatever the data shows. However, in-vitro studies of ultramolecular dilutions routinely show a clear biological effect.
The BBC confidently asserted in its coverage that no one has been able to reproduce evidence of this, which in fact it has, repeatedly (Belon P et al. Histamine dilutions modulate basophil activation. Inflamm. Res. 2004; 53: 181-188).
Pragmatic clinicians may be more interested in the excellent outcome data from the four NHS homoeopathic hospitals, which receive a constant stream of referrals of patients who have already 'tried everything'.
For this data, and a digest of systematic reviews of homoeopathy, see: www.trusthomeopathy.org/case/res_toc.html
The available evidence is problematic in many ways, but clearly it gives neither a ringing endorsement of homoeopathy nor any indication that it is worthless. We need more appropriate research in this area, not, as The Lancet prematurely concluded, none.
Attacking NHS homoeopathy will, if successful, leave this intriguing and useful therapy solely in the hands of lay practitioners with little scientific training and less contact with the rest of clinical medicine. Is this really what we want?
Dr Andrew Morrice