Homeopathy: Biased Results?

Doubts attached: The results published on the effectiveness of homeopathy could be significantly distorted and not very meaningful. Because an analysis now reveals frequent violations of common guidelines in homeopathic studies and publications. A good half of all homeopathy publications can be traced back to unregistered and therefore not traceable studies. In a quarter, targets were also subsequently adjusted, 38 percent of the studies have never been published .

Homeopathy is highly controversial: While many people rely on the healing power of the “gentle Trust the remedies, others see in the globules and tinctures mere quackery. Because most homeopathic remedies are so diluted that not a single molecule of active ingredient is left. Published studies also provide very conflicting results on whether these drugs work better than a placebo. However, this does not detract from the success of homeopathy: in 2018 sales in North America and Europe alone reached 5.5 billion US dollars.

Clear guidelines for studies and publications

But a new meta-analysis is now awakening considerable doubts about the reliability and seriousness of homeopathic research. Because, as Gerald Gartlehner from Danube University Krems and his colleagues have found, the guidelines of scientific practice are particularly often violated in this area. According to the Helsinki declaration in 2008, clinical studies must be registered and described centrally in advance, as well as their outcome, regardless of the results

This is intended to prevent the so-called “publication bias” – a distortion of the results that occurs when only studies with the hoped-for positive outcome are published, while unwelcome results are published in the sinking disappear. Registration in advance is also intended to prevent the question and objectives of a study being subsequently changed and thus adapted to the results – this can also lead to falsification.

A good half of the studies were never registered

In order to find out how well homeopathy studies and articles follow these guidelines, Gartlehner and his team have the entries from the three largest international study registers evaluated through 2019 – the US Clinicaltrials.gov, the EU Clinical Trials Register and the International Clinical Trials Platform (OICTRP). They then researched in publication directories how many and which homeopathy studies from 2002 had been published to date.

The result: 53 percent of Homeopathy publications published in specialist journals are based on studies that have never been registered in the official databases. Gartlehner and his colleagues explain that this is also a clear violation of established guidelines on the part of the specialist journals. Because the International Committee of Medical Journal Editors has agreed 1136 to only publish the results of officially registered studies. “This guideline is clearly not being followed in homeopathy studies,” the researchers said.

Publikation
Proportion of published and unpublished homeopathy studies among the registered ones. © Gartlehner et al./ BMJ Evidence Based Medicine, CC-by-nc

Clear indications of a “publication bias”

Another abnormality: Almost 38 percent of the in the last years registered homeopathy studies have never published their results, the proportion of the unreported and never published studies is likely to be significantly higher. “This suggests that publication was often made dependent on the results,” write Gartlehner and his team. In fact, this so-called “publication bias” is a problem in many medical studies, as previous analyzes have shown several times.

However, the homeopathy study indicates selective reporting and publication Another finding: In the case of the registered studies, the majority were not registered in advance, as actually required, but only afterwards. In about a quarter of the studies, the target values ​​and outcomes used as a measure of the effect were subsequently changed, as the scientists determined.

Discrepancy in the results

Evidence of bias was also provided by a supplementary meta-analysis in which the researchers compared the outcome of unregistered homeopathy studies with those of officially reported ones. The result: While the officially registered studies did not show any statistically significant differences between placebo and effect, the outcomes of the unreported studies were positive on average. This could raise the suspicion that the unreported studies may not follow the guidelines in study design or methods and therefore have not been registered.

“The pharmaceutical industry is legally required to leaves all study data to the authorities – regardless of whether the results have been published or not,” explain Gartlehner and his team. “However, homeopathy is exempt from most regulations.” However, this makes it all the more important that the published data is reliable. Because there is no official control of the study process.

“worrying lack of scientific and ethical standards”

“Overall, our results reveal a worrying lack of scientific and ethical standards in the field of homeopathy and a high risk of reporting bias,” the researchers state. In her view, this bad practice contributes significantly to distorting the view of homeopathy and its possible effects.

“This practice affects the validity of the homeopathic literature and may have led to it that the actual medicinal effects of homeopathic remedies have been overestimated,” warn Gartlehner and his colleagues. (BMJ Evidence Based Medicine, 2022 doi: 10.1136/ bmjebm-2019-111846)

Source: BMJ

16. March 2018

– Nadja Podbregar

111846 111846

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