Our Research:

Systematic reviews suggest that homeopathy has a greater effect than placebo, however the mechanisms of its action are unknown. The clinical effects of homeopathy could be attributed to the specific effects of the remedy and/or to the contextual effects of the consultation process; these factors have not been critically evaluated. We have developed a model that will attempt to separate the consultation effects from the specific effects due to the remedy. We propose to investigate this design in a chronic condition, rheumatoid arthritis, where previous research has evaluated both classical and complex homeopathic interventions. The following protocol describes the study design. The aims of this exploratory trial are to assess the feasibility of the study design, identify effect sizes of the consultation, the complex treatment, and the individualised remedy, as well as possibly efficacy, for the two types of homeopathic treatment and the homeopathic consultation. Data collection is proposed in 2004.

This study was a multi-centred, international study; our unit was responsible for 3 centres within the United Kingdom.
Objectives To evaluate the effectiveness of homeopathy compared to conventional treatment in acute respiratory and ear complaints in a primary care setting.
Design International, multicenter, prospective outcome study.
Setting: Patients, presenting themselves with at least one chief complaint: acute (£ 7 days) runny nose, sore throat, ear pain, sinus pain or cough, were recruited at 57 primary care practices in Austria (8), Germany (8), the Netherlands (7), Russia (6), Spain (6), Ukraine (4), United Kingdom (10) and the USA (8) and given either homeopathic or conventional treatment.
Primary outcome criterion Response rate, defined as ‘complete recovery’ or ‘major improvement’ after 14 days of treatment according to the patients’ assessments.
Results A total of 1,577 patients could be evaluated of which 857 received homeopathic (H) and 720 conventional (C) treatment. The most frequent chief complaints were cough in children and sore throat in adults. The majority of patients in both groups reported their outcome after 14 days of treatment as complete recovered or major improved with no significant differences in children (H: 88.5%; C: 84.5%) and adults (H: 85.6%; C: 86.6%). The unadjusted odds ratio (OR) of this primary outcome criterion was 1.40 (0.89-2.22) for children and 0.92 (0.63-1.34) for adults. Adjustments for demographic differences at baseline did not significantly alter the OR. Other outcome criteria after 7 and 28 days also showed no significant difference in response rates between both treatment groups. However, onset of improvement within the first 7 days after treatment occurred significantly faster in both children (p=0.0488) and adults (p=0.0001) receiving homeopathic treatment compared to conventional treatment. Adverse drug reactions occurred more frequently in adults receiving conventional treatment compared to the homeopathy group (C: 7.6%; H: 3.1%, p=0.0032).
Conclusion In primary care, the outcome of homeopathic treatment for acute respiratory and ear complaints appears to be equal to that of conventional treatment. 

ObjectiveTo evaluate the efficacy of homoeopathic immunotherapy on lung function and respiratory symptoms in asthmatic people allergic to house dust mite.
Design Double blind randomised controlled trial.
Setting 38 general practices in Hampshire and Dorset.
Participants 242 people with asthma and positive results to skin prick test for house dust mite; 202 completed clinic based assessments, and 186 completed diary based assessments. Intervention After a four week baseline assessment, participants were randomised to receive oral homoeopathic immunotherapy or placebo and then assessed over 16 weeks with three clinic visits and diary assessments every other week.
Outcome measure Clinic based assessments forced expiratory volume in one second (FEV1), quality of life, and mood. Diary based assessments: morning and evening peak expiratory flow, visual analogue scale of severity of asthma, quality of life, and daily mood. Results There was no difference in most outcomes between placebo and homoeopathic immunotherapy. There was a different pattern of change over the trial for three of the diary assessments: morning peak expiratory flow (P=0.025), visual analogue scale (P=0.017), and mood (P=0.035). At week three there was significant deterioration for visual analogue scale (P=0.047) and mood (P=0.013) in the homoeopathic immunotherapy group compared with the placebo group. Any improvement in participants’ asthma was independent of belief in complementary medicine.
Conclusion Homoeopathic immunotherapy is not effective in the treatment of patients with asthma. The different patterns of change between homoeopathic immunotherapy and placebo over the course of the study are unexplained.

Many patients seek help from practitioners of complementary and alternative medicine (CAM). Patients’ prior knowledge of CAM and desire for egalitarian relationships with medical practitioners have been shown to increase CAM use, as have higher scores on the Absorption scale (a measure of anxiety and "self-absorption"). Other personality scales do not predict CAM use.
Although users of CAM might not agree, a common view among scientists is that CAM outcomes are mediated through a placebo effect; that is, patients improve because they expect to do so. Our aims in the study described here were to assess the validity of the Attitudes toward Alternative Medicine Scale (AAMS) and to determine whether asthmatic patients who had positive attitudes toward and beliefs about CAM showed greater positive changes in outcomes.

Four double-blind, randomized, placebo-controlled clinical trials of asthma or rhinitis treated with homeopathic immunotherapy (HIT) at a 30C potency have been published. The most recent study, involving house dust mite allergic asthmatics, failed to confirm a therapeutic improvement at the end of the study, but did provide preliminary evidence for an oscillation in outcome (both physiological and subjective) in with verum treatment to placebo. In this paper we show how such an oscillation is consistent with a complexity theory interpretation of how the body functions as a whole and speculate on why different studies have produced different results. If the complexity theory interpretation is correct, then this will have a significant impact on the design of clinical trials in homeopathy and possibly, other complementary medical interventions.

Aims To investigate if ultramolecular homeopathy has any clinical effects. This was assessed using the proving of the homeopathic remedy Belladonna given at an ultramolecular dose (30C), as a model. A proving states that when a homeopathic remedy is given to a healthy person, they will experience symptomatic effects specific to that remedy. If ultramolecular doses are clinically active, the Belladonna 30C group should experience more true Belladonna proving symptoms than the placebo group.
Methods Healthy subjects (n = 253), aged 18–30 years, took part in this double-blind, randomized placebo-controlled study. Total study duration was 4 weeks. Subjects were randomized before 1 week placebo run-in. They received 2 weeks of treatment intervention (Belladonna 30C or placebo) and were followed up for 1 week. Subjects recorded any symptoms experienced during the total study period on a daily basis using a structured questionnaire. Symptom diaries were analysed blind to determine if each subject had proved or not (based on predefined criteria). The main outcome was the proportion of subjects who had proved in each treatment group.
Results No significant group differences in proving rates were observed [Belladonna provers N = 14 (13.9%); placebo provers N = 15 (14.3%); mean difference − 0.4%, 95% confidence interval − 9.3, 10.1] based on intention to treat analysis. Primary outcome was not affected by seasonality or the individual's attitude to complementary medicine.
Conclusion Ultramolecular homeopathy had no observable clinical effects.

Homeopathic pathogenetic trials (or provings) provide the foundations for the clinical practice of homeopathy. The most recent review of proving studies indicated that provings are generally of poor methodological quality. Methods to improve the quality and scientific rigour are needed to critically assess the clinical basis of homeopathy. This paper describes a methodology using a symptom diary with a selection of predefined remedy specific symptoms [proving questionnaire (PQ’s)]. The PQ was developed as an alternative to the traditional qualitative proving methods in an attempt to provide a quantitative method that could rigorously validate the original provings. This review considers the advantages and disadvantages of this approach and provides suggestions for future work in this area.

A number of authors have recently discussed the possible role entanglement in homeopathy.  Walach et al have published a homeopathic proving which they interpreted as demonstrating entanglement between placebo and verum groups in a proving. The lack of a ‘run-in’ period was a weakness of this trial.
We present further results of our proving of Belladonna which show that subjects who reported symptoms during the placebo run-in period (‘presentiment provers’) were more likely to report symptoms during the treatment period.  This data suggests and the observations of Walach et al may be explicable by conventional mechanisms including differential reporting and constitutional type.

Objective Homeopaths are traditionally taught to identify provers based on factual evidence in the materia medicas. The objective of the study was to determine the degree by which homeopaths employ clinical experience and intuition, within a questionnaire based proving study, to enable them to make their proving decision.
Materials and Methods Three experienced independent homeopathic clinicians/proving researchers rated whether N=211 subjects, who took part in a randomised, double blind placebo controlled questionnaire based proving study of Belladonna 30c, had proved. Each rater made their proving decision based solely on symptoms reported in the subject’s questionnaire; the raters had no personal contact with the subjects. The degree to which each rater employed clinical experience and/or intuition to enable their decision was recorded. The primary outcome was the process of homeopathic decision making.
Results All raters reported using a combination of both clinical experience and intuition to classify the majority of subjects, although mean reported scores were higher for clinical experience than intuition. Clinical experience was significantly associated with classifying non provers (relative to provers and those classified as undecided) in rater 1(F=9.3, N=112, P<0.001) ad rater 2 (F=46.2, N=71, P<0.001); and these raters were significantly more likely to report a high score for clinical experience when classifying non provers [rater 1 (c 2 = 15.45, DF=2, P<0.001) and rater 2 (c 2 = 44.32, DF=2, P<0.0010)]. All raters increased their use of intuition to classify provers, and intuition was significantly associated classifying provers compared to non provers [(Rater 2, F=6.03, N=76, P=0.003) and undecided (rater 3, F=5.42, N=22, P=0.005). Only rater 3 was significantly more likely to classify provers based on high intuition scores (c 2 = 13.79, DF=2, P<0.001).
Conclusion Despite homeopaths being provided with factual evidence alone, classifying a prover was not associated with reported use of clinical experience. Intuition was however associated with classifying a prover in two of the three raters. Issues regarding the education of homeopaths are highlighted. 

Objectives A homeopathic proving states that when a homeopathic remedy is given to a healthy person, they will experience symptomatic effects specific to that remedy. The aim of this study was to assess if attitudes about complementary and alternative medicine (CAM) predicted proving outcome.
Design An exploratory study nested in a double blinded randomized controlled proving trial of the remedy Belladonna C30.
Subjects Two hundred and six (206) healthy subjects took part in the reproving trial of whom 29 (14%) proved.
Interventions Subjects completed the Attitudes to Alternative Medicine Scale prior to participating in the proving trial (n = 206) and after the proving trial was completed (n = 77).
Outcome measures The primary outcome was whether attitude to CAM predicted proving outcome.
Results Attitudes about CAM at baseline did not predict proving outcome (χ2 = 35.34, df = 36, p = 0.50) and attitudes to CAM did not alter after taking part in the proving trial for either provers or non provers.
Conclusion Subjects classified as being provers in a proving trial did not have significantly different attitudes about CAM than nonprovers. The experience of proving the study remedy did not alter the prover's attitudes about CAM.