To Your Health: NLM update Transcript

Homeopathy's equivocal evidence base: 09/14/2015

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine (NLM).

Here is what's new this week in To Your Health, a consumer health oriented podcast from NLM, that helps you use MedlinePlus to follow up on weekly topics.

While the evidence about homeopathy is easy to follow on two recommended NLM websites, a recent debate in BMJ suggests the weight of evidence regarding homeopathy's clinical efficacy remains equivocal and disputable.

In one of BMJ's occasional head to head expert debates, one expert notes that some research suggests homeopathy is clinically useful, while a peer suggests the evidence underlying its clinical efficacy is inconclusive — if not scientifically irrational.

An advocate of homeopathy in BMJ suggests several systematic reviews and meta-analyses (both general and condition specific) suggest homeopathy can be clinically efficacious. More specifically, the advocate adds the Swiss government recently suggested homeopathy may be effective to treat upper respiratory tract infections and allergies.

The advocate of homeopathy notes a German website provides almost 1,120 clinical trials about homeopathy, which include about 300 randomized clinical trials.

The advocate writes (and we quote): 'doctors should put aside bias based on the alleged implausibility of homeopathy. When integrated with standard care homeopathy is safe, popular with patients, improves clinical outcomes without increasing costs, and reduces the use of potentially hazardous drugs...' (end of quote).

Yet, a homeopathy critic counters in BMJ that homeopathy's clinical efficacy is rarely confirmed within more rigorous clinical trials. The critic implies the degree of evidence about the effectiveness of homeopathy declines as research assessments become more sophisticated or state-of-the-art.

The critic cites a comprehensive 2015 Australian evaluation of homeopathy that concluded current scientific evidence suggests (and we quote): 'homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious' (end of quote).

To backup, the almost biopolar conclusions reached by BJM's critic and advocate underscore the extent that contemporary research fails to settle a two century-old debate about homeopathy's alleged clinical benefits and its risks.

A website about homeopathy (from the National Center for Complementary and Integrative Health — NCCIH — at NIH) explains homeopathy is an alternative medical system that was developed in Germany starting in the 18th century.

The NCCIH website (which is accessible within the 'specific conditions' section of MedlinePlus.gov'scomplementary and integrative medicine health topic page) explains one of the reasons homeopathy remains controversial stems from the fact its active ingredients are diluted significantly in clinical application.

The NCCIH website writes (and we quote): 'it is not possible to explain in scientific terms how a remedy containing little or no active ingredient can have any effect. This, in turn, creates major challenges to rigorous clinical investigation of homeopathy remedies' (end of quote).

Meanwhile, despite homeopathy's equivocal evidence-base and bioavailability, two NLM-based websites provide plentiful access to state-of-the art research about homeopathy. For example, PubMed Health (NLM's comprehensive resource of systematic reviews and meta-analyses) provides access to research that evaluates homeopathy's effectiveness when applied to an array of specific medical conditions including: the induction of labor, dementia, chronic asthma, irritable bowel syndrome, insomnia, fibromyalgia, anxiety, hot flashes, cancer, the flu, and headaches.

To search for evidence about homeopathy, just type 'homeopathy' in PubMed Health's search box.

Homeopathy also is one of the many alternative medical remedies covered within MedlinePlus.gov's complementary and integrative medicine health topic page.

For example, a helpful overview of complementary and integrative health (from the Mayo Foundation for Medical Education and Research) is available in the 'start here' section of MedlinePlus.gov's complementary and integrative medicine health topic page.

MedlinePlus.gov's complementary and integrative medicine health topic page additionally provides links to the latest pertinent journal research articles, which are available in the 'journal articles' section. Links to relevant clinical trials that may be occurring in your area are available in the 'clinical trials' section. You can sign up to receive updates about complementary and integrative health as they become available on MedlinePlus.gov.

To find MedlinePlus.gov's complementary and integrative medicine health topic page please type 'CAM' in the search box on MedlinePlus.gov's home page, then, click on 'complementary and integrative medicine (National Library of Medicine).'

As the debate continues, we encourage the use of MedlinePlus.gov and PubMed Health to stay abreast of the evidence about homeopathy's clinical effectiveness — as well as the status of other complementary or alternative medical remedies.

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