Page 19 - Autumn 23

continued from page 15
Controversy remains about homeopathy in certain countries and there is often an accusation of reporting bias, particularly a paper in BMJ by Gartlehner et all entitled Assessing the magnitude of reporting bias in trials of homeopathy.
According to Gartlehner 38% of registered trials in homeopathy remained unpublished and 25% of registered and published trials contained inconsistencies in primary outcomes and they concluded that this showed a ‘concerning lack of scientific and ethical standards in in the field’. However, reporting bias is well known to affect all areas of medical research and in conventional medicine, studies have shown that on average half (range 23.6- 83%) of registered trials do not publish their results on time and inconsistencies in primary outcomes occurs in a third of trials (18-43%) So on further analysis, homeopathic research compares very well to conventional medical research in terms of reporting bias.
From the veterinary perspective, Petra Weiermayer gave her talk on clinical observational studies and the fact that they are an important methodological approach with currently unrealised potential in the field of homeopathic veterinary medicine. With relatively minor adjustments the practical guidelines and checklists available to researchers in designing, conducting and reporting observational studies in human homeopathic medicine which are explained in the STROBE-VET guidelines can be adapted for veterinary use.
The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement was
first published in 2007 and again in 2014. The purpose of the original STROBE was to provide guidance for authors, reviewers, and editors to improve the comprehensiveness of reporting; however, STROBE has a unique focus on observational studies. Although much of the guidance provided by the original STROBE document is directly applicable, it was deemed useful to map those statements to veterinary concepts, provide veterinary examples, and highlight unique aspects of reporting in veterinary observational studies.
Explanation and Elaboration Document for the STROBE- Vet Statement: Strengthening the Reporting of Observational Studies in Epidemiology-Veterinary Extension - PubMed (nih.gov)
Explanation and Elaboration Document for the STROBE- Vet Statement: Strengthening the Reporting of Observational Studies in Epidemiology – Veterinary Extension - O'Connor - 2016 - Zoonoses and Public Health - Wiley Online Library
Single studies, if there are enough of them and if they are subject to rigid protocols, will build up our evidence base.
So, my conclusions from the conference were as follows:
1 Homeopathic research is serious science, there are labs all over the world studying the effects of homeopathy in a variety of models and living systems. We have evidence form plants, dyes, cell lines and human and animal research.
2 I think we must accept that homeopathic research is looked at with greater scrutiny and also must accept that the scientific process is rigorous and not unusual for a paper to be rejected 6 or 7 times before being accepted for publication.
3 We have inherited the RCT trials from our conventional colleagues, but we need to make our own models and study designs with qualitative studies as well as quantitative ones. Stay faithful to our homeopathic principles. What is important to us is patient reaction and our patient requirements.
4 There is untapped potential in individual observational studies and there are protocols and guidelines out there to help with the correct analysing and reporting methods. There is a lot of support out there if we reach out to our colleagues.
5 We no longer need to feel isolated or attacked, there is solid evidence to back us up. The debate has moved on from ‘Does Homeopathy work?’ to ‘How does it work?’
In the work being done on homeopathic research, it was felt that ultimately, we won’t just find an answer to how homeopathic remedies work, the research will amplify our knowledge of the human body and how it works and will improve our knowledge of human health.
Homeopathy is more than just a remedy, it is a process.
17