Quo vadis Research in Homeopathy? On Clinical Trials and Drug Provings in Homeopathy
Abstract: The significance of scientific investigation for homeopathy is in dispute, and there is no agreement as to whether the research that has been conducted so far has confirmed the efficacy of homeopathic preparations or not. Additionally, there are questions within the field of homeopathy that have not yet been clarified, for example the efficacy of homeopathic remedies which have been prepared in different ways, stability, etc. Traditionally, case reports were used to demonstrate the success of homeopathy. These case reports are still highly convincing but, strictly speaking, no causal conclusions can be drawn from them as to the efficacy of homeopathic treatment. For this reason approximately 140 controlled clinical trials in the area of homeopathy have been conducted so far. In some cases homeopathic treatment showed no better results than the control therapy; in other cases there were positive results in favor of homeopathy, with a weak statistical significance. Statistical significance cannot be the only criterion of the methodological quality and the persuasive power of clinical trials. A catalogue of 16 minimal requirements for controlled clinical trials is included in this paper, From the perspective of these requirements the trials published so far neither prove nor disprove the efficacy of homeopathic treatment. In order to establish a meaningful study design it is necessary to be able to estimate the extent and frequency of the expected effects. With respect to homeopathy this condition is not fulfilled: lt is unclear how often healing or improvement in a patient's condition, when they occur, can be ascribed to the homeopathic treatment. Presumably, this is rarely the case; if this is true, only large-scale studies will be able to provide the necessary data. Randomized, placebo-controlled, doubleblind clinical trials have been shown to have various essential drawbacks. 'Therefore, a new kind of study design is called for. This new design should avoid the shortcomings of both traditional case reports and randomized clinical trials. The advantages and disadvantages of these extreme forms of investigation have been described in the present paper. One solution for this problem might be a monophasic, prospective single-case study, which still has to be worked out in detail. Everything that has been said about controlled clinical trials also applies to homeopathic drug proving. Here, as well, new and convincing research approaches are necessary.
Keyword(s): Hom÷opathie: kontrollierte klinische Studien