“If you only consider high quality trials, they show homeopathy doesn’t work”

This statement, though frequently repeated, is completely wrong.

The most recent comprehensive systematic review found that, when analysing only the highest quality randomised controlled trials, homeopathic medicines prescribed during individualised treatment are 1.5- to 2.0-times more likely to have a beneficial effect than placebo.1

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The erroneous idea that high quality trials show homeopathy doesn’t work seems to originate from a misunderstanding of the trends seen in two comprehensive systematic reviews (Linde 19972 and Shang 20053which singled out high-quality trials.

Here is what the data in these studies actually tells us:

In 1997 Klaus Linde and co-workers identified 89 clinical trials that showed an overall odds ratio of 2.45 in favor of homeopathy over placebo. There was a trend toward smaller benefit from studies of the highest quality, but the 10 trials with the highest Jadad score still showed homeopathy had a statistically significant effect.” 4

The Shang 2005 study set out to compare the quality of trials in homeopathy and conventional medicine, by looking at 110 similar trials from each of the two disciplines. They assessed 21 of the homeopathy trials and 9 of the conventional trials as being of “higher quality”. Shang’s team decided to analyse only 8 of these high quality trials, which produced the negative result that homeopathy is no better than placebo, but if you analyse all 21 higher quality trials of homeopathy, the results are positive, suggesting that homeopathy does have an effect beyond placebo.5 

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1.Mathie RT et al. Randomised placebo-controlled trials of individualised homeopathic treatment: systematic review and meta-analysis. Systematic Reviews, 2014; 3: 142
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2. Linde K. et al. Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet, 1997; 350:834–843 | PubMed

3. Shang A, Huwiler-Muntener K, Nartey L, et al. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. Lancet, 2005; 366: 726–32 | PubMed

4. Hahn RG. Homeopathy: Meta-Analyses of Pooled Clinical Data. Forsch Komplementmed, 2013;20:000–000 Published online: October 17, 2013 DOI: 10.1159/000355916 | PubMed

5. Lewith G, Professor of Health Research at Southampton University, Letter to the Editor, Positive Health, December 2008 | Full Text

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High quality trials show it doesn't work