Homeopathy in Healthcare: Effectiveness, Appropriateness, Safety, Costs - An HTA report on homeopathy as part of the Swiss Complementary Medicine Evaluation Programme

Cover......Page 1
Frontmatter......Page 2
Copyright......Page 4
Table of Contents......Page 6
1 Introduction 
......Page 10
2 Backgroundand objectives of HTA 
......Page 14
2.1 Background......Page 15
2.2 Objectives......Page 16
3 Introduction to thespeciality of homeopathy –principles and definition 
......Page 18
3.3 Homeopathic pharmacology......Page 19
3.5 Medicines: their manufacture, application and mode of action......Page 20
3.6 The concept of disease in homeopathyand conventional medicine......Page 21
3.8 Other therapies known as homeopathy......Page 22
3.10 References......Page 23
4 Homeopathy: Research andResearch Problems(preclinical and clinical) 
......Page 24
4.1 Introduction and Research Problems......Page 25
4.2.1 Fundamental physico-chemical research......Page 26
4.2.3 Animal studies......Page 27
4.3.1 Classification......Page 28
4.3.2 An outline of clinical trials......Page 29
4.3.3 Future research......Page 30
4.4 References......Page 31
5 General problems withclinical trials in research 
......Page 36
5.1 The Problems with Randomized Clinical Trials......Page 37
5.2 The Risk of Bias in Clinical Trials......Page 40
5.3 Problems with the Formal Evaluation of Clinical Trialsin Meta-analyses......Page 48
5.4 References......Page 53
6 HTA Homeopathy:Methods and Material 
......Page 56
6.1 Project Implementation......Page 57
6.2.2 Data sources used......Page 58
6.2.3 Systematic literature search: general search strategyand article selection......Page 63
6.2.4 Systematic literature search for individual HTA aspects:search strategy and article selection......Page 64
6.3.1 Extraction and evaluation of data / procedure......Page 65
6.3.2 Extraction and evaluation of data......Page 66
6.3.3 Evaluation categories......Page 67
6.4 Data Synthesis......Page 68
6.5.1 Database research ‘Homeopathy’......Page 69
6.5.2 Special search: URTI (Upper Respiratory Tract Infection)......Page 71
6.5.4 Cost-effectiveness......Page 72
6.6 References......Page 75
7 International Utilisationof Complementary MedicalApproaches 
......Page 76
7.2 Methodology......Page 77
7.3.2 Study design......Page 78
7.3.3 CAM definitions......Page 85
7.3.5 Frequency of CAM use......Page 88
7.3.6 Estimation of satisfaction with CAM and CAM effectiveness......Page 92
7.3.7 Reasons for using CAM......Page 94
7.4 Discussion......Page 95
7.5 Conclusion......Page 96
7.6 References......Page 97
8 CAM Conditions and Usein Switzerland 
......Page 100
8.1 Conditions......Page 101
8.2.2 Methodology......Page 103
8.2.3 Results......Page 104
8.2.5 Conclusion......Page 106
8.2.6 List of study numbers (referred to in the diagrams)......Page 107
9 Overview of SystematicReviews on the ClinicalEfficacy of Homeopathy 
......Page 110
9.2 Literature Search......Page 111
9.3.1 Reviews on general effectiveness......Page 112
9.3.2 Reviews on special indications:......Page 115
9.3.3 Reviews on special interventions......Page 116
9.3.3 Reviews on special indications with special intervention......Page 117
9.4.1 Research question......Page 118
9.4.2 Selection of studies......Page 120
9.4.3 Selection and evaluation of data/information......Page 122
9.4.4 Data synthesis......Page 123
9.5 Discussion and Conclusion......Page 126
9.6 List of Excluded Studies with Reasons for Exclusion......Page 127
9.7 References......Page 133
10 Clinical Studieson the Effectivenessof Homeopathy for URTI/A(Upper Respiratory TractInfections and AllergicReactions) 
......Page 136
10.2 Outcome of Literature Search......Page 137
10.3.1 Population, study design and implementation......Page 149
10.3.2 Intervention and control therapy......Page 150
10.3.4 Results......Page 151
10.4 Discussion......Page 152
11 Safety of Homeopathic Use 
......Page 168
11.2 Responses to Treatment......Page 169
11.5 Scientific Research......Page 170
11.7 References......Page 171
12 Cost-effectivenessof Homeopathy 
......Page 172
12.1 Introduction......Page 173
12.2 Methods of Health Economics......Page 175
12.3 Use of CAM......Page 176
12.5 Cost-effectiveness......Page 177
12.7 Data and Studies for Homeopathy......Page 178
12.8.1 NFP 34......Page 180
12.8.2 Further data from Switzerland......Page 181
12.9 International CAM Studies and Surveys: Patients......Page 182
12.11 Pilot Projects in Germany......Page 183
12.12.2 Cost-effectiveness of complementary medical methods......Page 186
12.12.3 Homeopathy......Page 197
12.13 References......Page 198
13 Full discussionof the HTA results 
......Page 202
13.1 References......Page 212
14 Synopsis 
......Page 214
14.2 Reviews......Page 215
14.3 Studies on the Indication Upper Respiratory Tract Infection/Allergy (URTI/A)......Page 216
14.5 Economy......Page 217