Despite its widespread use, homeopathy lacks a comprehensive and robust evidence base. Funders, researchers, and practitioners need direction on how to improve clinical research on homeopathy to provide robust evidence on its efficacy, comparative effectiveness, and safety. The authors discuss findings from a review of homeopathic clinical research studies and from expert panel deliberations to identify gaps in research quality and areas studied.

The State of Homeopathic Research

Patricia M. Herman, Cindy C. Crawford, Margaret A. Maglione, Sydne J. Newberry, Ian D. Coulter

ResearchPublished Sep 25, 2024

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Despite its widespread use, homeopathy lacks a comprehensive and robust evidence base. Funders, researchers, and practitioners need direction on how to improve clinical research on homeopathy to provide robust evidence on its efficacy, comparative effectiveness, and safety.

In this report, the authors examine the state of homeopathic research by critically assessing the overall quality of homeopathic clinical research literature. They discuss the results of their review of 99 studies in the Homeopathic Intervention Studies database, assessing each for internal, external, and model validity using standard and homeopathy-specific instruments. The studies targeted a wide variety of populations and conditions. Among infants, children, and adolescents, immunological function conditions were the most commonly studied. Studies of adults addressed more varied conditions, including pain, respiratory issues, mental health, and cognition. Studies were conducted in many Western and Asian countries, with the largest proportion (30 percent) conducted in India and the next most (9 percent) conducted in Germany.

The authors also present the results of an expert panel convened in 2023 to identify gaps in research quality and in areas studied. Panelists answered questions regarding the sufficiency of the existing evidence base and deliberated on recommendations for future homeopathic clinical research.

Key Findings

The review of the homeopathic clinical research literature identified many areas in which the quality of the studies could be improved

  • About two-thirds of the 85 controlled trials in the sample had either high (42 percent) or unclear (24 percent) risk of bias according to internationally recognized standards for internal validity.
  • Of the 14 observational (cohort) studies included in the sample, more than one-third did not control for important confounders in the outcome analyses.
  • Regarding external validity, adherence was reported in less than one-third of the studies.
  • Almost half of the studies did not describe the experience and training of the practitioners.
  • Forty percent of all reviewed studies and 79 percent of observational studies did not report on safety.
  • Regarding model validity, which is essential for replicability and interpretability, less than two-thirds of the reviewed studies were consistent with homeopathic principles.

Panelists were split on whether the homeopathic research literature is missing important areas of study and offered various suggestions for future research

  • Priority areas include acute conditions, conditions seen most common in practice, conditions for which conventional medical options are lacking, conditions seen in children and women, and conditions for which some efficacy has been established.
  • Panelists identified as a priority establishing how to describe the homeopathic practice so that it can be interpreted in a meaningful manner by the research community.
  • Substantial discussion addressed the need to bring more research expertise into homeopathic research studies, both by better training homeopathic researchers and by collaborating with conventional medicine research groups.

Recommendations

  • Funders, researchers, and journal editors and reviewers should require authors to follow the Consolidated Standards of Reporting Trials (CONSORT) and guidelines specific to reporting homeopathic studies, such as the Reporting Data on Homeopathic Treatments criteria for trials.
  • All homeopathic studies should proactively monitor and report on adverse events as recommended in CONSORT and several other guidelines for the study of homeopathy.
  • Organizations with credibility and acceptability within the homeopathic research community should identify methodological exemplar studies and make them known to researchers, so that these studies can be used to guide future research.
  • Training and support for homeopathic researchers should be increased, and where possible, research teams examining homeopathy should include experienced medical researchers who have an excellent track record for high-quality research.
  • Funders and researchers should consider studies determining the validity of the Critical Appraisal Tool for Homeopathic Intervention Studies tool as a quality measure for studies of homeopathy.
  • An organization with credibility and acceptability within the homeopathic research community should assemble representative panels of stakeholders to obtain agreement about a small number of areas of focus for future research, with each area reflecting a specific population, treatment or prevention of a condition, and type of homeopathy in a particular country. These stakeholder panels could also address such research quality issues as determining the level of quality sufficient for making clinical decisions and setting policy guidelines, weighting the relative importance of different aspects of external and model validity, and establishing how to describe homeopathic practice.

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RAND Style Manual
Herman, Patricia M., Cindy C. Crawford, Margaret A. Maglione, Sydne J. Newberry, and Ian D. Coulter, The State of Homeopathic Research, RAND Corporation, RR-A3242-1, 2024. As of October 10, 2024: https://www.rand.org/pubs/research_reports/RRA3242-1.html
Chicago Manual of Style
Herman, Patricia M., Cindy C. Crawford, Margaret A. Maglione, Sydne J. Newberry, and Ian D. Coulter, The State of Homeopathic Research. Santa Monica, CA: RAND Corporation, 2024. https://www.rand.org/pubs/research_reports/RRA3242-1.html.
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This research was funded by the Samueli Foundation and carried out by the RAND Research Across Complementary and Integrative Health Institutions (REACH) Center within the Quality Measurement and Improvement Program in RAND Health Care.

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