A systematic review of homeopathic pathogenetic trials

<p>0-090 Homeopathy, used by 500 millionpeople worldwide according to theWHO, remains controversial. Provings,now known as HomeopathicPathogenetic Trials ( HPTs) remainone of the foundation stones of Homeopathy.They involve the administrationof substances in Homeopathicdilutions to groups of healthy peoplewith the aim of producing pathogenicsymptoms. This is the first review ofHPTs which meet modern standardsfor trial design. A systematic reviewwas undertaken, using MEDLINE,AMED, EMBASE , CINAHL, andHOMINFORM. From 503 papers, 11papers covering 15 trials met the fullinclusion criteria. The aim was to assesswhether Homeopathic substancescould produce symptoms differentfrom those produced by placebo. Trialstook place in different countriesusing different medicines. Outcomeswere assessed by structured andunstructured diaries and questionnaires.Statistical meta-analysis was possiblefor two of the outcome measures: 1.A comparison of the level of symptomspre-defined as typical of thetrial medicine across the verum andplacebo group and 2.A comparison ofoverall proving reactions in the twogroups. No significant differenceswere found.All of the included trials were of goodmethodological quality in terms ofstandard RCT design. However theyall shared a major weakness in relationto homeopathic theory. The theorysuggests that only susceptible individualswill respond to a particularmedicine, whether in clinical practiceor in a pathogenetic trial, and that thepercentage of individuals who are susceptiblewill be small. For such trialsparticipants should first be screenedfor susceptibility before randomisationinto the main trial. Otherwisetrials are likely to show no differencebetween verum and placebo groupssince the level of symptoms producedby placebo is always significant andis unlikely to be less than any realpathogenetic effects produced by themedicine in the small percentage oftrial participants who are susceptible.Presenter: Jim Rogers Senior Lecturer</p>