Homeopathy 2006; 95(01): 61-62
DOI: 10.1016/j.homp.2005.11.005
Letter to the Editor
Copyright © The Faculty of Homeopathy 2005

Open letter to the Editor of The Lancet from the Swiss Association of Homoeopathic Physicians (SVHA)

A. Thurneysen

Subject Editor:
Further Information

Publication History

Publication Date:
02 January 2018 (online)

The study on homoeopathy by Shang et al [ 1 ] from the Department of Social and Preventative Medicine, University of Berne, Prof Egger, published in The Lancet on the 27/8/2005, has been part of the Swiss Complementary Medicine’ Evaluation Programme (PEK). For the last 2 years the authors have been stating in the media that homoeopathic effects are placebo effects, but have withheld the basis of their statement until this year. We do not consider this procedure as very fair. Professor Egger invited us to make our criticism of his study public in a formal ‘Letter to the Editor’. However, our letter was not accepted for publication. We therefore decided to make our comments public in the form of this open letter.

The meta-analysis of homoeopathy by Aijing Shang et al, formed part of the Swiss ‘Complementary Medicine Evaluation Programme’ (PEK). The meta-analysis compares 110 homoeopathic and 110 matched trials of allopathy.

The meta-analysis may be statistically correct. But its validity and practical significance can be seen at a glance: not one single qualified homoeopath would ever treat one single patient in clinical practice as presented in any of the 110 analysed trials! The study cannot give the slightest evidence against homoeopathy because it does not measure real individual (classical) homoeopathy. It confounds real homoeopathic practice with distorted study forms violating even basic homeopathic rules. The correct selection of the homoeopathic remedy almost entirely depends upon the totality of individual symptoms and signs whereas most homoeopathic RCT's use standardized interventions with hardly any practical value and a great inherent chance of producing false negative effects. Even the very few classical studies analysed are distorted by lack of proper follow-up and durations in the narrow frame of RCT's.

Despite this, almost three quarters of the included 110 homeopathic studies of homeopathy show positive results according to previous reviews and meta-analyses.[ 2–7 ] How does the result from Berne turn out so negative? The negative outcome is based strongly upon a statistical extrapolation from a very small number (8!) of large trials with negative or slightly positive results. From a homoeopathic point of view all the large trials are of very low quality and lack external validity.[ 8–15 ] Furthermore, in our opinion it is not legitimate to apply the funnel plot method to all the different studies of a complex intervention and mix them in one pot.

There are more serious concerns about the meta-analysis. The report is not transparent. No details of the 110 trials are given nor do the statistical graphics make clear which trial belongs to which result. Thus the study is a ‘black box’ and the reader has to believe it or analyse the trials himself. The study selection is questionable as well: the authors ‘are confident that we identified a near-complete set.… of published trials’. But the above mentioned reviews and meta-analyses include 300–400 homoeopathic RCT's of homeopathy. Therefore, the study is incomplete and violates the standards and rules of the Cochrane collaboration. A more detailed analysis of the study from homoeopathic side is given in German in the statement of the Swiss homoeopathic doctors.[ 16 ]

The conclusion that homoeopathic effects are due to placebo is scientifically untenable. We wonder how and why Lancet could ignore these facts and announce the ‘end of homoeopathy’. Recent epidemiological studies[ 17,18 ] in the last years as well as a recent study also Berne University on ADHD[ 19 ] give evidence of a good practical utility and effectiveness of homoeopathy in clinical practice.