Rachel Roberts is the Executive Director of the Homeopathy Research Institute (HRI) and has worked for the Institute since 2010. HRI is a UK-based charity dedicated to promoting high quality research in homeopathy at an international level.
Reprinted with permission from the website of HRI: https://www.hri-research.org/
What do you consider to be the three most important quality characteristics for good research?
R.R. When assessing the quality of homeopathic studies, I always look for what I think of as ‘research without compromise’ – that is, studies which ask the right questions, use the highest quality conventional scientific research techniques, and also manage not to interfere with, or compromise, the quality of the homeopathic care given to the patients.
That means that good research: 1. Investigates potential new treatments for patients in urgent clinical need. There is no point researching homeopathy for conditions where conventional medicine does a great job already. It is far more important to test whether homeopathy can help patients for whom there is currently no sufficiently effective treatment available, or existing treatments are problematic – causing unwanted side-effects or being contraindicated.
- Uses study designs and outcome measures (tools to measure the impact of the treatment being tested) which are widely accepted throughout the scientific world
- Involves appropriate homeopathic prescribing – the choice of medicine(s), dosage, and duration of treatment should reflect how similar patients would be treated by well-trained homeopathic prescribers in the real world. One of my current favourite papers which is a perfect example incorporating all these elements is an Israeli study (Lotan et al. 2020), which tested whether homeopathy could prevent seroma (fluid build- up) after mastectomy in patients with breast cancer.
Seromas commonly cause severe discomfort and delay healing, yet there is no conventional treatment other than fitting drains after surgery to remove the fluid. This ‘gold standard’ study – a randomised, double-blind placebo-controlled trial – found that the women treated with homeopathic medicines after surgery (Arnica montana and Bellis perennis) were able to have their drains removed 2.4 days earlier (18% sooner) than the women given placebo.
Regrettably, many women have to undergo this kind of surgery, so it would be great to see more research in this area, with the aim of being able to introduce this simple homeopathic treatment protocol as an easy to deliver, inexpensive addition to routine ‘post-op’ care for such patients.
How do you rate the standards in homeopathy research?
R.R. Standards in homeopathy research compare very well with other fields, including conventional medical research. In fact, according to the results of a recent study published in the BMJ (Gartlehner et al. 2022), the homeopathy research sector appears to be out-performing conventional medicine in regard to scientific and ethical standards, with lower levels of ‘reporting bias’ – a problem which can lead to over- estimation of benefits of treatments.
One example they looked at was how often researchers changed the ‘primary outcome’ i.e. which symptom/measurement being monitored during a study was considered the main ‘result’ of the study. This ‘moving the goal posts’ to give more favourable results was found to occur in 25% of homeopathy research studies, whereas it happens in 43% of conventional medicine studies (Shah K et al, 2020).
I have been involved in the homeopathy research field for over a decade now and it has been great to see more high-quality studies coming through. In fact, according to Dr Robbert van Haselen, Director of the World Integrated Medicine Forum, the homeopathy evidence base shows a clearly observable trend of increasing study quality in recent years.
So, research is being done at a higher and higher standard – we just need to keep producing more of it!
Is there a research landscape that deals specifically with homeopathy?
R.R. Yes, there are a number of organisations around the world dedicated to homeopathy research – essentially one on every continent – each tending to have a slightly different focus.
On 25 June 2022 HRI is holding a one-day online conference, ‘Key Collaborations in Homeopathy Research’ and funnily enough, the opening session is titled ‘The landscape of homeopathy research’. This will give people an opportunity to learn more about some of the most prominent homeopathy research organisations and research teams in the world, including leading experts from Israel, India, Brazil, Switzerland, Austria and of course HRI from the UK.
What topics are scientists currently working on in the field of homeopathy research?
R.R. One exciting area of research is investigating the use of homeopathy beyond clinical medicine, as part of sustainable and organic agriculture. For example, using non-toxic homeopathic products instead of chemical pesticides, or replacing antibiotics given to livestock with homeopathic medicines, has the potential to reduce environmental pollution and reduce contamination of the food chain.
Which of these will be discussed at the upcoming HRI Online 2022 event?
R.R. Professor Leoni Bonamin from Brazil, who has over two decades of experience conducting laboratory- based research on homeopathic medicines, will be presenting at the HRI online congress. This gives us a rare chance to hear directly from one of the world’s leading experts in the field, about the work of multiple different research teams across Brazil who are investigating and using homeopathy in many different ways, from farmers using homeopathy to improve the welfare and quality of their cattle, to vets using homeopathy to reduce the impact of yellow fever in monkeys, to the latest findings from her own laboratory experiments.
Do you agree with the statement that “benefits of homeopathy are just the placebo effect”?
R.R. Absolutely not. This is a commonly mentioned theory, but the data just isn’t there to back it up. On the contrary, the most rigorous research shows that homeopathic medicines have a true clinical effect above and beyond the placebo effect you see with all medical treatments.
Laboratory researchers in multiple countries have shown that homeopathic medicines can have biological effects in plants, fish, tadpoles and even isolated blood cells. Those results simply cannot be explained by placebo. And when we look at clinical research, the 2014 landmark review by Dr Robert Mathie showed that individually prescribed homeopathic medicines are 1.5 to 2.0 times more likely to have a beneficial effect than placebo.
The clinical effect he identified from the homeopathic medicines is similar to that for several conventional drugs, such as sumatriptan for migraine, fluoxetine for major depressive disorder and cholinesterase inhibitors for dementia. Once you see this kind of positive data being generated across all sub-fields of research – laboratory experiments, veterinary research and human research – the overall trend is pretty hard to ignore.
Which research topic from homeopathy would you like to work on in the near future?
R.R. Personally, I have always wanted to see a clinical trial of the homeopathic medicine Symphytum. We have a lot of anecdotal evidence to suggest that this plant, used in traditional phytotherapy to improve fracture healing and reduce pain from broken bones, has the same benefits in homeopathic form.
This would have been my chosen PhD project years ago, had HRI not grown exponentially over the past decade, demanding all my time. Without enough hours in the day to do both, I have always wondered whether someone else would take on this topic!
As I see it, if you could demonstrate that a homeopathic medicine influences bone healing, confirmed by state-of-the-art imaging techniques, this could be game-changing. It would not only open up a new avenue for helping patients but could also provide an indisputable demonstration of what homeopathy is capable of, for those who still struggle to accept that homeopathic medicines are a valuable addition to the ‘medical toolbox’, which can be used effectively alongside the traditional pharmaceutical drugs we have all used for decades.
References 1. Lotan AM et al. Arnica montana and Bellis perennis for seroma reduction following mastectomy and immediate breast reconstruction: randomized, double-blind, placebo-controlled trial. European Journal of Plastic Surgery, 2020: 43, 285–294. 2. Gartlehner G et al. Assessing the magnitude of reporting bias in trials of homeopathy: a cross- sectional study and meta-analysis. BMJ Evidence-Based Medicine, 2022; eFirst 3. Shah K et al. Outcome reporting bias in Cochrane systematic reviews: a cross-sectional analysis. BMJ Open, 2020;16;10:e032497.
Rachel Roberts is the Executive Director of the Homeopathy Research Institute (HRI) and has worked for the Institute since 2010. She graduated with honours from the University of Birmingham (UK) with a degree in biological sciences, specialising in physiology. She also graduated from the College of Homeopathy in London in 1997 and subsequently worked as a homeopath in private practice until 2012. Rachel Roberts has taught homeopathy and medical science at various institutions in and outside the UK. About HRI HRI is a UK-based charity dedicated to promoting high quality research in homeopathy at an international level. More information: www.hri-research.org Contact Chris Connolly firstname.lastname@example.org www.hri-research.org
- Lotan AM et al. Arnica montana and Bellis perennis for seroma reduction following mastectomy and immediate breast reconstruction: randomized, double- blind, placebo-controlled trial. European Journal of Plastic Surgery, 2020: 43, 285–294.
- Gartlehner G et al. Assessing the magnitude of reporting bias in trials of homeopathy: a cross sectional study and meta-analysis. BMJ Evidence-Based Medicine, 2022; eFirst
- Shah K et al. Outcome reporting bias in Cochrane systematic reviews: a cross-sectional analysis. BMJ Open, 2020;16;10:e032497
HRI is a UK-based charity dedicated to promoting high quality research in homeopathy at an international level. More information: www.hri-research.org
Chris Connolly email@example.com | www.hri-research.org