Methodological rigour and results of clinical trials of homoeopathic remedies

We studied security of randomisation vis-g-vis treatment effect in 26 clinical trials of homoeopathic remedies, designated >>high quality<< in a published meta-analysis, An invited international panel of acknowledged expertsscored security of randomisation at two stages: firstly using the published trial reports, and secondly using these plus further clarificatory information provided on request by trialists. The quality of blinding of outcome assessment was also scored, by two of the present authors. Security of randomisation at the two stages, and quality of blinding, were each plotted against treatment effect size as calculated in the meta-analysis. A regressionanalysis featuring stage 1 judgements showed no positive trend; that featuring stage 2 judgements showed a visible but not statistically significant trend. No conclusions could be drawn from the data concerning quality of blinding in relation to treatment effect. Of the 26 trials, only seven showedno effect or an effect favouring non homoeopathic treatment, and all threestudies with objectively verifiable outcomes fell into this category. Retrospective verification of study quality is not an exact science, and the available data are thin; our findings are thus unlikely to sway anyone's antecedently held opinion about the scientific plausibility of homoeopathy, Large, multi centre trials of homoeopathic remedies, with minimum involvement of practitioners in random allocation, and careful blinding, represent the best way of advancing the debate.