Evidence based medicine is the scientific look at how medicine works. The evidence base medicine must be throughly examined by researchers with peer reviews. Specific procedures must be followed. Data is examined. Much of the data is discarded if the quality is deemed to be not satisfactory. Researchers conducting the trials do not know which patients are getting the placebo and which person is actually receiving the medicine. These trials have been used to evaluated prescription drugs.
Critics point that few homeopathic trials exist showing this type of complementary medicine actually works. The ones that do show homeopathy working are too small and not well designed. The trials that do show promise have not been replicated enough. Larger well designed trials show homeopathy does not work. Supporters point out that there are many trials showing homeopathy does work. Many of these are well designed.
Which side is right is an interesting question? The answer is neither side is correct according to evidence based medicine. Evidence based medicine requires several larger trials in the 700 to 1000+ people. These larger trials are replicated over and over again to see if the results are reproduced. Smaller trials produce too many errors. Larger trials in the 700 to 1000+ people range that are replicated over and over again are what evidence based medicine deems to be effective.
There are many limitations to evidence based medicine such as publication bias and randomization of trial users. However, these limitations can be addressed if the trial is done correctly.
The biggest issue with evidence based medicine is the true cost. The only people doing evidence based medicine are drug companies because they can afford the cost of these trials. Most trials with homeopathy are just too small to draw any definite conclusions. Evidence based medicine can not really make a judgement on homeopathy because the large trials and replications have not been performed.
The largest trial in homeopathy is with Oscillococcinum. This trial was a large one with about 700 plus patients showing reduction of the flu. It also had a similar trial showing this medicine did nothing to help prevent the flu. All the other trials in homeopathy are just too small for evidence base medicine to say whether these conclusions are accurate or not.
Sometimes evidence base medicine gives results that people do not like. Evidence based medicine says breast cancer screening need not be done on a yearly basis. They recommend doing breast cancer screening every 2 years for women 50 to 74 years of age. The test was not really necessary for women younger than 50 with no history of breast cancer. However, many doctors disagreed with this outcome. Many doctors feel it is still necessary to do breast screening on a yearly basis for many women.
This may happen with homeopathy trials on a large scale. I think the skeptics will not accept the results if homeopathy works in a large scale well replicated trial. Proponents will still continue using homeopathy if the results from a large scale trial that was replicated many times over was negative.
Going forward what type of homeopathy trials should be done due to a limited budget. Should homeopaths do small trials with classical homeopathy where all remedies are prescribed by a doctor? These type of trials in large numbers may prove to be extremely problematic and expensive. It would be very difficult to do this type of trial with replication and limiting publication bias. Another option would be to carry out further large trials with Oscillococcinum to see if a replication is possible. Should these trials with a couple hundred of people even be carried out since evidence based medicine says their conclusions are pretty much irrelevant?
What trials do you think homeopathy should be doing? Should they go after the promising results such as Oscillococcinum or do classical homeopathic trials or hundreds of small trials for various health conditions?