The aim of this paper was to systematically review the available clinical evidence of homeopathy in urological conditions. Relevant trials published between Jan 1, 1981 and Dec 31, 2017 were identified through a comprehensive search. Internal validity of the randomized trials and observational studies was assessed by The Cochrane Collaboration’s tool and methodological index for non-randomized studies (MINORS) criteria respectively, homeopathic model validity by Mathie’s six judgmental domains, and quality of homeopathic individualization by Saha’s criteria.
Four controlled (three randomized and one sequentially allocated controlled study) trials and 14 observational studies were included. Major focus areas were benign prostatic hypertrophy and kidney stones.
All the observational studies generated positive findings. One of the four controlled trials had ‘adequate’ model validity, but suffered from ‘high’ risk of bias. None of the non-randomized studies was of good methodological quality. Nine observational studies had ‘adequate’ model validity and quality criteria of individualization. The evidence from the controlled trials of individualized was inconclusive.
The authors concluded that, although observational studies appeared to produce encouraging effects, lack of adequate quality data from randomized trials hindered to arrive at any conclusion regarding the efficacy or effectiveness of homeopathy in urological disorders. The findings from the RCTs remained scarce, underpowered and heterogeneous, had low reliability overall due to high or uncertain risk of bias and sub-standard model validity. Well-designed trials are warranted with improved methodological robustness.
This new systematic review of homeopathy offers a number of surprises:
- When evaluating the effectiveness/efficacy of a therapy, observational studies are not informative and should therefore not be included in the analyses.
- The paper is badly written (what was the editor thinking?).
- The review is of poor methodological quality (what were the reviewers thinking?).
- The literature searches are now almost three years old; this means the review is outdated before it was published.
- The conclusion of the review is confusing; essentially, the authors admit that there is no good evidence for homeopathy as a treatment of urological conditions. Yet they seem to be bending over backwards to hide this message the best they can.
- The journal in which the paper was published is the ‘Journal of Complementary & Integrative Medicine‘; suffice to say that it is not a publication many people would want to read.
- The article was authored by an international team with impressive affiliations:
- Homoeopathy University, Jaipur, Rajasthan, India.
- Former Director General, Central Council for Research in Homoeopathy, Ministry of AYUSH, Govt. of India, New Delhi, India.
- Central Council for Research in Homoeopathy, Ministry of AYUSH, Govt. of India, New Delhi, India.
- Secretary, Information and Communication, Liga Medicorum Homoeopathica Internationalis, Izmir, Turkey.
- Central Council for Research in Homoeopathy, Ministry of AYUSH, Govt. of India, Izmir, India.
- Department of Neuro-Urology, Swiss Paraplegic Centre, Nottwil, Switzerland.
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- State National Homoeopathic Medical College, Lucknow, Govt. of Uttar Pradesh, India.
- Department of Materia Medica, National Institute of Homoeopathy, Ministry of AYUSH, Govt. of India, Kolkata, India.
- Independent Researcher, Champsara, Baidyabati, Hooghly, West Bengal, India.
- Homoeopathic Drug Research Institute, Lucknow, under Central Council for Research in Homoeopathy, Ministry of AYUSH, Govt. of New Delhi, New Delhi, India.
I am pleased with my last point: at least one feature that is impressive about this new review.