Homeopathy in Healthcare is the first publication in English of the health technology assessment (HTA) of homeopathy commissioned by the Swiss government. It is particularly important for three reasons:
A. Firstly, the HTA is a report on homeopathy which was produced by appropriately qualified professionals without a vested interest. The thirteen members of the investigating team included ten trained in conventional medicine, of whom six were also trained in homeopathy; the other three had training in physics, electrical engineeering and sociology. Eight of the thirteen held academic positions, of whom six had been involved in research in the field of complementary and alternative medicine (CAM).
In contrast, the House of Commons Science and Technology Committee’s Evidence Check 2: Homeopathy was supported by only three MPs out of a committee of fourteen. Of these three MPs, two had not attended any of the hearings, one because he was not even a member of the committee until after the hearings were concluded. Two of these three MPs also had links to the pharmaceutical industry or to Sense About Science, an organisation opposed to homeopathy which received 35.7% of its donation funding from the pharmaceutical industry in 2004-09. A key advisor of the committee, Chris Tyler, “pioneered the Science and Technology Committee’s ‘Evidence Check’ programme”, having previously worked for Sense About Science, where he had written Sense About Homeopathy, which was an attack on homeopathy. Tyler has provided no evidence of any training in medicine or homeopathy.
B. Secondly, the HTA was produced according to scientific principles, and was based on the proper application of the principles of evidence based medicine (EBM) in relation to assessing treatments for use in clinical practice. It explicitly concluded “that the individual CAM interventions, especially homeopathy, were effective, under Swiss conditions safe and, as far as could be judged from the trial situation, also cost-efficient” (p. 2).
In contrast, the House of Commons Science and Technology Committee’s Evidence Check 2: Homeopathy ignored scientific principles and the proper application of EBM, accepted only randomised controlled trials (RCTs) as valid evidence, and then relied heavily on a single meta-analysis of such trials: Shang et al. On the basis of this distorted approach, the Evidence Check concluded that there was no evidence that homeopathy was more effective than placebo.
C. Thirdly, Homeopathy in Healthcare specifically and completely rejects the meta-analysis by Shang et al., which was based on research commissioned as part of the HTA, and which has been used as the basis of attacks on homeopathy ever since 2005. Shang et al. is described as an example of “The danger of biased evaluation due to one-sided focus on purely formal criteria without thematic differentiation” (p. 39).
In contrast, as noted above, the House of Commons Science and Technology Committee’s Evidence Check 2: Homeopathy relied heavily on Shang et al. despite having been provided with all the evidence of its scientific deficiencies.
What this means is that the expert evidence is in favour of homeopathy as an effective, safe and economic approach to medicine, whereas opposition to homeopathy is based on the views of unqualified people with vested interests, or on those who are prepared to employ invalid and inappropriate research to support their case.
Gudrun Bornhöft and Peter Matthiessen (eds), Homeopathy in Healthcare – Effectiveness, Appropriateness, Safety, Costs: An HTA report on homeopathy as part of the Swiss Complementary Medicine Evaluation Programme, trans. from the German by Margaret M Saar (Berlin, Heidelberg, New York: Springer-Verlag, 2011).
Aijing Shang, Karin Huwiler-Müntener, Linda Nartey, Peter Jüni, Stephan Dörig, Jonathan A.C. Sterne, Daniel Pewsner and Prof. Matthias Egger, ‘Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy’, Lancet, 366 (2005), 726-732.
To download a review by William Alderson of Homeopathy in Healthcare click here.
A review by Dana Ullman is available here.
A review is also available here on the Faculty of Homeopathy website.