OBJECTIVE: To establish whether there is evidence of the efficacy of homoeopathy from controlled trials in humans. DESIGN: Criteria based meta-analysis. Assessment of the methodological quality of 107 controlled trials in 96 published reports found after an extensive search. Trials were scored using a list of predefined criteria of good methodology, and the outcome of the trials was interpreted in relation to their quality. SETTING: Controlled trials published world wide. MAIN OUTCOME MEASURES: Results of the trials with the best methodological quality. Trials of classical homoeopathy and several modern varieties were considered separately. RESULTS: In 14 trials some form of classical homoeopathy was tested and in 58 trials the same single homoeopathic treatment was given to patients with comparable conventional diagnosis. Combinations of several homoeopathic treatments were tested in 26 trials; isopathy was tested in nine trials. Most trials seemed to be of very low quality, but there were many exceptions. The results showed a positive trend regardless of the quality of the trial or the variety of homeopathy used. Overall, of the 105 trials with interpretable results, 81 trials indicated positive results whereas in 24 trials no positive effects of homoeopathy were found. The results of the review may be complicated by publication bias, especially in such a controversial subject as homoeopathy. CONCLUSIONS: At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias. This indicates that there is a legitimate case for further evaluation of homoeopathy, but only by means of well performed trials.

Clinical Trials as Topic↗

PubMed1991

Acupuncture and asthma: a review of controlled trials.

BACKGROUND: Published controlled trials of acupuncture in asthma have often contained a small number of subjects and the results are contradictory. Controlled trials have been reviewed to determine whether clearer conclusions could be obtained by assessing as many studies as possible according to methodological criteria. METHODS: A literature search produced 13 trials on the efficacy of acupuncture in the treatment of patients with asthma. These studies were reviewed on the basis of 18 predefined methodological criteria. A maximum of 100 points for study design could be earned in three main categories: (a) adequate study population, (b) adequate intervention, and (c) adequate measurement of effects. RESULTS: The quality of even the eight better studies (more than 50% of the maximum score) proved to be mediocre. No study earned more than 72% of the maximum score. The results from the better studies are highly contradictory. CONCLUSIONS: Claims that acupuncture is effective in the treatment of asthma are not based on the results of well performed clinical trials.

Acupuncture Therapy↗

PubMed1990

Belief in the efficacy of alternative medicine among general practitioners in The Netherlands.

A survey among 293 GPs in the Netherlands showed that many believe in the efficacy of common alternative procedures. High scores were especially found for manual therapy, yoga, acupuncture, hot bath therapy and homoeopathy. Other procedures, such as iridology, faith healing and many food supplements, were considered less useful.

Attitude of Health Personnel↗

PubMed1990

Acupuncture and chronic pain: a criteria-based meta-analysis.

A literature search revealed 51 controlled clinical studies on the effectiveness of acupuncture in chronic pain. These studies were reviewed using a list of 18 predefined methodological criteria. A maximum of 100 points for study design could be earned in four main categories: (a) comparability of prognosis, (b) adequate intervention, (c) adequate effect measurement and (d) data presentation. The quality of even the better studies proved to be mediocre. No study earned more than 62% of the maximum score. The results from the better studies (greater than or equal to 50% of the maximum score) are highly contradictory. The efficacy of acupuncture in the treatment of chronic pain remains doubtful.

Acupuncture Analgesia↗

PubMed1989

[Vitamin C and the common cold; review of a megadosis literature].

Explore the source record for details and available documents.

Ascorbic Acid↗

PubMed1989

Vitamin E and cardiovascular disease.

Randomized clinical trials of the effects of Vitamin E on complaints of intermittent claudication and angina pectoris are reviewed, and their methodological shortcomings are considered. Mechanisms by which Vitamin E might act in cardiovascular disease are discussed. The evidence about the possible pharmacological actions of Vitamin E supports the need for randomized clinical trials. It is concluded that Vitamin E may have a positive effect, especially in intermittent claudication.

Angina Pectoris↗

PubMed1989

Garlic, onions and cardiovascular risk factors. A review of the evidence from human experiments with emphasis on commercially available preparations.

1. Claims for beneficial effects on cholesterol levels, fibrinolytic activity, and platelet aggregation are attributed both to fresh garlic and onions (or their extracts) and to commercially available preparations. 2. Regarding fresh garlic, the claims have been confirmed, but so far only at very high dosages. 3. For onions and commercially available supplements contradictory results have been reported. 4. All published trials showed severe methodological shortcomings. Some trials were not randomized and/or not blinded whilst this was possible, and in only one of every three studies more than 25 patients participated in each treatment group. In no trial was prognostic comparability of the treatment and the control groups ascertained. At the moment there is inadequate scientific justification for garlic supplementation.

Allium↗