‘Scientific method’ and its ‘golden rules’ are misused by powerful people to crush simple truth of homeopathy

‘Scientific method’ and its ‘golden rules’ are misused by powerful people to crush simple truth of homeopathy

Chandran K C

It is really terrifying to see how ‘scientific method’ and its ‘golden rules’ are misused by powerful people to crush simple truth of homeopathy, and to shield their vested anti-people business interests in healthcare industry. It is disheartening to see how our respected ‘men of science’ and ‘democratic rulers’ have turned mere puppets of global healthcare corporate kings and greedy big pharma giants.  I am totally shattered to witness this dark ‘other side’ of science and democracy which I cherished so much all my life.

I have in front of me the ‘NHMRC INFORMATION PAPER- Evidence on the effectiveness of homeopathy for treating health conditions’ published in March 2015 by National Health and Medical Research Council, Australia, after an elaborate study of all published materials(http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cam02a_information_paper.pdf ). I have been studying it minutely for the last few days, along with all its appended documents.

Learned NHMRC ‘hired’ pundits have given their final verdict of homeopathy in this ‘Information Paper’: “Homeopathy is Good for Nothing!” It is “Nothing better than Placebo!” Homeopathy should not exist- FINISHED!

NHMRC concludes: “Based on the overall findings of the assessment of the evidences of effectiveness of homeopathy, NHMRC has reached the following final conclusions: There is no reliable evidence from research in humans that homeopathy is effective for treating the range of health conditions considered. There were no health conditions for which there was reliable evidence that homeopathy was effective.  Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness. People who are considering whether to use homeopathy should first get advice from a registered health practitioner. Those who use homeopathy should tell their health practitioner, and should keep taking any prescribed treatments. For some health conditions, studies reported that homeopathy was not more effective than placebo. For other health conditions, some studies reported that homeopathy was more effective than placebo, or as effective as another treatment, but those studies were not reliable. To be confident that the reported health benefits of homeopathy were not just due to chance or the placebo effect, they would need to be confirmed by other well-designed studies with an adequate number of participants. For the remaining health conditions it was not possible to make any conclusion about whether homeopathy was effective or not, because there was not enough evidence.”

After going through the Information Paper as well as the appended documents carefully, I feel that NHMRC showed some sort of undue haste in arriving at such a totally negative conclusion regarding the effectiveness of homeopathy. They seem to be more inclined towards ‘excluding’ materials and evidences rather than evaluating them, and declare all seemingly positive evidences as “inconclusive” and “unreliable”. This hurry sparks doubts in my mind regarding the real goal of this project. Important question is, is it appropriate for scientific method to utilize ‘lack of sufficient evidence’ as an ‘evidence against’ homeopathy? Does ‘search for truth’ means ‘denying truth’?

Before advancing further with this critique, we have to know the people behind this ‘Information Paper’, and their real objectives in taking up a work of this type, that may have catastrophic effects up on a low-cost medical system currently accepted by millions of people around the world for their day to day health care requirements. It is very serious, since the ‘paper’ recommends that “homeopathy should not be used to treat health conditions”! It is so serious that recommendations made in this paper may be utilized by interested parties to undermine even the very existence of homeopathy as a system of medical practice. Before declaring homeopathy is ineffective, NHMRC could have conducted some well designed studies and researches of their own, instead of arriving at hasty conclusions from assessments of already ‘published materials’ only, that too by hired ‘contractors’. I wonder what held them back from doing this, if they were really dedicated to finding out truth in the common interest of the society! At least in the interest of finding truth, they could have concluded their report by recommending the scientific community to undertake serious research works on homeopathy, since all the works so far done were found to be ‘methodologically flawed’, ‘unreliable’ and ‘inconclusive’!

NHMRC introduced themselves as follows: “NHMRC is Australia’s peak body for supporting health and medical research by funding the best research, selected through a competitive peer review process. NHMRC also develops health advice for the Australian community, health professionals and governments in the form of public health and clinical practice guidelines, Statements, Information Papers and evidence reviews. NHMRC also provides advice on ethical behavior in health care and in the conduct of health and medical research. The work of NHMRC is guided by its Strategic Plan, and defined by the National Health and Medical Research Council (NHMRC) Act 1992. The Strategic Plan covers a three year period and is submitted to the Health Minster for approval, prior to being tabled in Parliament. The NHMRC Strategic Plan 2013–2015 has identified ‘claiming benefit for human health not based on evidence’ as a major health issue for consideration.”

According to them, “this Information Paper is an example of NHMRC’s function to ‘advise the community’ under section 7(1)(a) of the NHMRC Act 1992. Published research on a topic of interest has been identified, analyzed and synthesized into a summary of the evidence for the Australian community, health professionals and policy makers. This information can then be utilized to assist people in making healthcare choices, guide clinical practice or influence policy and perhaps new funding approaches, all of which lead to improvements in health and health care delivery. Within our health system, there are practices which are currently not based on sturdy evidence. Health and medical research is the means by which we test the value of procedures, processes, systems and products offered to patients, or proposed as preventive means by the health system and its policy and decision makers. NHMRC is a strong advocate for the development and use of evidence to inform policy and practice and in recent years, NHMRC and other health research funding bodies have increased funding for such research. NHMRC is of the view that when offering treatments for illness, all registered health practitioners must give consideration to the evidence for the effectiveness of such treatments. This consideration should be reflected in their professional ethics and clinical practices.”

According to the NHMRC report, the ‘Information Paper’ is the outcome of their assessment of the evidence of the effectiveness of homeopathy, based on: a) an overview of published systematic reviews by an independent contractor, b) an independent evaluation of information provided by homeopathy interest groups and the public, and, c) consideration of clinical practice guidelines and government reports on homeopathy published in other countries. Kindly do not misunderstand, NHMRC did not conduct any research by themselves about homeopathy that led them to a judgment. It was only an “assessment” based on available published materials.

Why did NHMRC conduct such an ‘assessment’ of homeopathy?  Listen what they say: “NHMRC is responsible for supporting health and medical research as well as providing Australians with advice based on best available evidence. This advice assists people in making informed decisions about their health care. This includes providing advice about the use of conventional therapies, as well as complementary and alternative medicines or traditional practices which, despite their longstanding history of use, may not have been demonstrated to be effective. Many health care practices and products are promoted as beneficial to health when there is little or no evidence to support these claims. In some cases these claims may mislead people to reject practices and treatments that are proven to be effective, in favor of non-evidence-based treatments. People who use homeopathy need to understand the potential benefits and risks to enable them to make an informed decision. Health practitioners also need to know what homeopathy is, be aware of the current scientific evidence from research on homeopathy, and understand any possible benefits and risks to patients—particularly when people decide to use homeopathy instead of other evidence-based treatments. For these reasons, NHMRC undertook an assessment of the evidence to provide Australians with reliable information on the effectiveness of homeopathy”.

I repeat my question once again: Why NHMRC did not conduct some well designed studies and researches of their own regarding the effectiveness of homeopathy, instead of arriving at hasty conclusions from assessments of already ‘published materials’ only, knowing well that they are ‘unreliable’ due to flawed methodology, that too by hired ‘contractors’? What held them back from taking up this most important task, if they were really dedicated to finding out truth in the common interest of the society! Why a responsible body such as NHMRC  could not hire a team to conduct such a research work strictly following the scientific methodology, so that ‘reliable’ and ‘conclusive’ output is ensured? If people at NHMRC were genuinely interested to know whether homeopathy works or not, it would have been the easiest way for them, rather than searching for ‘unreliable’ databases!

Only imaginable reason is, NHMRC actually wanted to build a defenseless case against homeopathy, rather than finding out the truth! It was their only goal mandated by their bosses- nothing else!

This work was overseen by the ‘Homeopathy Working Committee’ established by the NHMRC. “Given their collective expertise in evidence-based medicine, study design, and complementary and alternative medicine research, the Homeopathy Working Committee also provided advice on how the evidence should be interpreted in developing an Information Paper.”

Who were the “experts” that constituted this “homeopathic working committee”, who “provided advice on how the evidence should be interpreted in developing a Information Paper” of this type?

See the list of Committee members and their credentials given in the Information Paper:

1. Professor Paul Glasziou, MBBS, PhD, FRACGP, General practitioner Professor and Director of the Centre for Research into EvidenceBased Practice, Bond University, Queensland Expert in evidence-based medicine

1. Professor Peter Brooks, AM, MBBS, MD (Lund), FRACP, FAFRM, FAFPHM, MDHonCausa, FRCP (Glas, Edin), Rheumatologist Director of the Australian Health Workforce Institute, University of Melbourne, Victoria (to September 2013) Executive Director Research, Northern Hospital, Epping, Victoria Former board member, Australian Centre for Complementary Medicine Education and Research, University of Queensland

1. Professor Frederick Mendelsohn, AO, MB BS, PhD, MD, FRACP Neuroscientist Former Chair in Medicine and Director of the Howard Florey Institute, University of Melbourne, Victoria

1. Mr John Stubbs, BA, DipAcct Consumer Executive Officer, canSpeak Honorary Associate, School of Medicine, University of Sydney, New South Wales Member, Australian Health Ethics Committee, NHMRC Member, Consumer Consultative Group, NHMRC

1. Associate Professor Evelin Tiralongo, BPharm(Hons), PhD, GradCertHigherEd Pharmacist Discipline head for complementary medicine teaching and research, School of Pharmacy and Griffith Health Institute, Griffith University, Gold Coast, Queensland Member, Clinical Trials Coordinating Centre, Griffith University Member, Society for Medicinal Plant and Natural Product Research

1. Dr Nikolajs Zeps, BSc(Hons), PhD Research scientist Director, St John of God Subiaco Hospital Research network Adjunct Professor School of Health Sciences, Curtin University Adjunct Professor, Centre for Comparative Genomics, Murdoch University Adjunct Associate Professor, School of Surgery and School of Pathology and Laboratory Medicine, University of Western Australia Adjunct Associate Professor, Faculty of Medicine, University of Notre Dame, Western Australia Founding Director, Australian Clinical Trials Alliance Member, Research Committee, NHMRC Member, Australian Health Ethics Committee, NHMRC: Triennium 2010–2012

1. Professor Chris Baggoley, AO, BVSc(Hons), MBBS, BSocAdmin, FACEM, FIFEM , Australian Government Chief Medical Officer

• As the overview only included systematic reviews, some individual studies of homeopathy may not have been considered (particularly recent studies published since the latest systematic reviews). This risk was offset by inviting homeopathy interest groups and the public to provide extra evidence at two stages of the review: before the overview and at public consultation on the draft of this Information Paper. From this process an additional 42 studies were considered as part of the assessment of the evidence. These studies did not alter the overall findings of the assessment of the evidence.

• To assess the quality of individual studies, the research group had to rely on the way that these were reported by systematic reviews. Details of study design (e.g. the outcomes measured and the length of follow up), the statistical significance of the results and the clinical importance of any reported health benefits were not always available. Also, the description of an individual study was sometimes inconsistent between systematic reviews. In these instances, the findings of the systematic review which was assessed to be of a higher quality was considered.

• It was not possible to separate the evidence for clinical homeopathy (in which the homeopath chooses one or more homeopathic medicines to treat a particular health condition) and individualized homeopathy (in which the homeopath matches all the person’s symptoms to a single homeopathic medicine), because most of the systematic reviews did not analyze these separately. Most of the studies used clinical homeopathy.

• It was not possible to make conclusions about the effects of homeopathy on each of the specific health outcomes (e.g. pain, mobility) relevant to a particular health condition (e.g. arthritis), because of the large number of outcomes and the different reporting of outcomes between the different systematic reviews. Instead, outcomes were aggregated for each health condition and a single conclusion made.

• It was often difficult in studies to find the details of other treatments with which homeopathy was compared. To interpret the studies that compared homeopathy with another treatment, it is necessary to understand whether the other treatment is an effective standard treatment. This information was often not available from the systematic reviews.

• It is also likely that some studies assessing homeopathic treatments have never been published. Searching of clinical trials registries can identify unpublished studies and enable researchers to obtain and analyze the results, but cannot identify studies that have not been registered. The overview identified only 10 systematic reviews that reported having considered publication bias, and only two of these made a comprehensive, systematic search for missing studies.”

1. As the overview only included systematic reviews, some individual studies of homeopathy may not have been considered

1. To assess the quality of individual studies, the research group had to rely on the way that these were reported by systematic reviews.

1. It was not possible to separate the evidence for clinical homeopathy (in which the homeopath chooses one or more homeopathic medicines to treat a particular health condition) and individualized homeopathy (in which the homeopath matches all the person’s symptoms to a single homeopathic medicine),

1. It was not possible to make conclusions about the effects of homeopathy on each of the specific health outcomes.

1. It was often difficult in studies to find the details of other treatments with which homeopathy was compared.

1. It is also likely that some studies assessing homeopathic treatments have never been published.

1. For some health conditions, this meant that no conclusion could be made on whether or not homeopathy was effective. For other conditions, this meant that NHMRC could not be confident that the results reported by studies were reliable.”

Out of these SEVEN ‘experts’, nobody belongs to the homeopathic community, or claims to have any ‘expertise’ or ‘knowledge’ about homeopathy. All of them belong to modern medical community, who represent a community having known ‘prejudices’ and ‘biases’ against homeopathy. Yet, the committee is called ‘Homeopathic Working Committee’! It is really a big fun to hear calling a body of ‘anti-homeopathic experts’ as ‘Homeopathic Working Committee! If their intentions were genuine, NHMRC should have included in this committee a couple of persons having expertise in homeopathy also, at least to give them a say and prove that there is no bias against homeopathy. Anti-homeopathic goal of NHMRC in taking up this task of ‘assessing’ homeopathy is evident from the constitution of this working committee itself.

 Let us come to the methodological aspects of NHMRC ‘assessment’.  It is consented that the assessment was based on “an overview of published systematic reviews by an independent contractor”. That means, it was that “independent contractor” who conducted the “overview of published systematic reviews” that led to the publication of this ‘Information Paper’.

NHMRC mentions in their ‘paper’ that they commissioned a professional research group OptumInsight (Optum) to do a thorough search of published research to find systematic reviews of studies (prospective, controlled studies) that compared homeopathy with no homeopathy or with other treatments and measured effectiveness in patients with any health condition. That means, OPTUM is the “independent contractor”.

The researchers of OPTUM searched databases of health publications to find systematic reviews published in English between 1 January 1997 and 3 January 2013. For each health condition, the research group collated the findings of the systematic reviews and assessed the quality and reliability of the evidence. The findings are described in detail in the Overview Report. The purpose of this approach was to use published systematic reviews as a way of identifying the body of evidence for homeopathic treatments. The professional research group of OPTUM did not accept the conclusions or interpretations of the systematic reviews, but instead considered the included studies. The professional research group evaluated the quality of each of the included studies, using the information provided by the systematic reviews.

Additional information was submitted by homeopathy interest groups and the public to NHMRC, for its consideration as a part of its review of homeopathy, on two occasions. The preliminary submitted literature on the effectiveness of homeopathy was provided by the Australian Homoeopathy Association and the Australian Medical Fellowship of Homeopathy as well as members of the public. During public consultation on the draft Information Paper, a range of stakeholders submitted 12  additional literature for consideration in the development of this Information Paper .

All submitted literature was assessed by OPTUM researchers to identify evidence within the scope of NHMRC’s assessment. Only the types of studies that were included in the overview (prospective, controlled studies) were assessed in detail. For each study included, OPTUM assessed the quality and reliability of the results and summarized the findings in a review of submitted literature. This evidence was considered when preparing this Information Paper.

Our study of NHMRC ‘Information Paper’ and their conclusions will not be complete unless we know the people behind OPTUM, whom NHMRC hired as “impartial contractors” to do the whole work. Then only you will understand that it is not an issue of ‘prejudice’ and ‘skeptic bias’, but a pre-planned, state-mediated, well financed,  global conspiracy against homeopathy, sponsored by international pharmaceutical lobbies. OPTUM is not “impartial contractors” or “hired researchers” as NHMRC tries to make out, but the real players with their own vested interests, who conducted and orchestrated the whole event for their powerful patrons in the big pharma and healthcare industry.

OPTUM introduces themselves in their website as a “health services and innovation company on a mission, with 94,000 people dedicated to improving the health system for everyone in it, powering MODERN HEALTHCARE by combining data and analytics with technology and expertise”. Visit www.optum.com to know the real role and stakes of this giant in global modern health care business.  OPTUM is a leading information and technology-enabled corporate health services business house with diverse interests and different areas of health care industry, including drug development, clinical trials, pharmaceuticals as well as medical insurance.   They also run their own pharma industry house known as ‘OptumRx’. OPTUM has a colossal presence in different spheres of international health care industry, mostly interested in eradicating all complementary medical systems including HOMEOPATHY, which may pose threat to their big pharma interests.

Now the picture is very clear. OPTUM is not “impartial contractors” or ‘job workers’ hired by NRHMC, but the executors of a global scale health industry conspiracy to “finish” HOMEOPATHY. Entrusting a team of anti-homeopathic experts as well as OPTUM for making “assessment” regarding effectiveness of homeopathy was actually  like appointing jackals as the caretakers of chickens!

If you go though the whole report, you will see how effectively and professionally OPTUM has done the work they were entrusted to do. Final outcome was pre-determined, and all “assessments” were aimed at that goal. Entrusting OPTUM as well as experts of anti-homeopathic professional interests for the ‘assessment’ of effectiveness homeopathy has actually proved to be like appointing ‘jackals’ as the caretakers of ‘chicken’!

See how the OPTUM researchers dealt with the 343 articles submitted by homeopathy interest groups and individuals and produced a BIG ZERO from them: “A total of 343 articles were submitted to NHMRC, of which a large majority (234) were of a research or publication type not meeting the inclusion criteria. A further 79 articles had already been included or considered in the Overview Report. On considering the remaining 30 articles, studies were excluded if they: covered an intervention not meeting the inclusion criteria; were of a research type not meeting the inclusion criteria; did not report on efficacy outcomes; the study design confounded the results; or were not published in English. This resulted in nine studies examining the effectiveness of homeopathy for the treatment of eight different clinical conditions identified for further assessment. Five of the eight conditions (otitis media, delayed-onset muscle soreness, depression, bruising, and sleep or circadian rhythm disturbances) were examined in the overview. The results of these studies were considered in relation to the body of evidence identified in the overview but did not alter the overall conclusions about the effectiveness of homeopathy because of their poor quality, poor design, poor reporting of the study design or method, or too few participants.”

See the fate of ‘public consultation’ submitted literature: “A total of 48 submissions were received from consumers, consumer groups, health care professionals, homeopathy practitioners and homeopathy organisations. Of the 153 articles cited in these submissions, 94 were excluded because they did not meet the criteria for the NHMRC review (e.g. they did not investigate the treatment of health conditions in humans, they had already been considered in an earlier stage of the NHMRC review, or they were not published studies). The remaining 59 studies, which had not been included in the overview report, were assessed against pre-determined criteria for consideration. After this assessment, 17 more of these studies were excluded because they did not meet the criteria for the NHMRC review. Of the remaining 42 published studies, three represented a single study, resulting in a final total of 40 studies assessing the effectiveness of homeopathy for the treatment of health conditions, compared with no homeopathy or with other treatment. For each study, the risk of bias was systematically assessed using a standardised method (the Cochrane Collaboration’s tool for assessing risk of bias) and analysed. The included studies investigated homeopathy for the treatment of 14 health conditions (16 studies) that were covered by systematic reviews included in the overview: rheumatoid arthritis, influenza-like illness, hot flushes, rhinosinusitis, ankle sprain, oral dryness, psychophysiological-onset insomnia, stress, dermatological reactions to radiotherapy, warts, osteoarthritis of the knee, chronic low back pain, upper respiratory tract infection and otitis media. Most studies were assessed to have a moderate, moderate-to-high or high risk of bias. Many of these studies were poorly designed, poorly conducted or poorly reported. In addition, the studies had too few participants to be able to detect differences in health outcomes between the treatment groups. The findings of these studies did not alter the overall conclusions of the NHMRC review. Although one small study with a low risk of bias favoured homeopathy for the treatment of cough in upper respiratory tract infections, this study did not have enough participants to outweigh the wider body of evidence considered in the overview”

“The OPTUM researchers searched databases of health publications to find systematic reviews published in English between 1 January 1997 and 3 January 2013. For each health condition, the research group collated the findings of the systematic reviews and assessed the quality and reliability of the evidence. The findings are described in detail in the Overview Report. The purpose of this approach was to use published systematic reviews as a way of identifying the body of evidence for homeopathic treatments. The professional research group did not accept the conclusions or interpretations of the systematic reviews, but instead considered the included studies. The professional research group evaluated the quality of each of the included studies using the information provided by the systematic reviews”.

Detailed assessments of NHMRC ‘Information Paper’ regarding effectiveness of of homeopathy in different classes of diseases are really amusing:

“There is no reliable evidence on which to draw a conclusion about the effectiveness of homeopathy, compared with placebo, for the treatment of these health conditions:  acne vulgaris, acute otitis media (inflammation of the middle ear) in children, acute ankle sprain, acute trauma in orthopaedic patients, amoebiasis and giardiasis (gastrointestinal conditions caused by parasites), ankylosing spondylitis, boils and pyoderma (types of skin infections), Broca’s aphasia in people who have had a stroke,  bronchitis, cholera, cough, chronic polyarthritis, dystocia (difficult labour), eczema, heroin addiction,  knee joint haematoma (bruising), lower back pain, nausea and vomiting associated with chemotherapy, oral lichen planus, osteoarthritis, proctocolitis, postoperative pain-agitation syndrome, radiodermatitis (skin damage caused by radiotherapy) in women with breast cancer, seborrhoeic dermatitis, suppression of lactation after childbirth in women who elect not to breastfeed, stroke, traumatic brain injury (mild), uraemic pruritis, vein problems due to cannulas in people receiving chemotherapy,

Why NHMRC reached this conclusion? “For each condition, only one study that compared homeopathy with placebo was found, and this study was unreliable. It was either poor quality (poorly designed or poorly done) or unknown quality, or it had too few participants to give a meaningful result, or both”.

Don’t laugh, please! They could find only “one study”. That was “unreliable” also! Why should they wait to jump into their pre-determined ‘conclusion’?

NHMRC ‘paper’ continues: “There is no reliable evidence that homeopathy is as effective as the other therapies for the treatment of these health conditions-  acute otitis media or otitis media with effusion (inflammation of the middle ear) in children (compared with antibiotics, mucolytic medicines, secretolytic medicines, antipyretic medicines, nasal sprays, or monitoring the condition but not providing treatment, allergic rhinitis (compared with antihistamines, cortisone or intranasal cromolyn sodium), anxiety or stress-related conditions (compared with lorazepam, diazepam or cognitive behavioural therapy), depression (compared with fluoxetine or diazepam) , eczema (compared with corticosteroids, antihistamines, or other unspecified therapies), non-allergic rhinitis (compared with aspirin, xylometazoline or other therapies), osteoarthritis (compared with paracetamol or various nonsteroidal anti-inflammatory drugs), upper respiratory tract infection (compared with anti-inflammatory drugs, antibiotics or other therapies).

“There is no reliable evidence on which to draw a conclusion about the effectiveness of homeopathy compared with other therapies for the treatment of these health conditions: burns (second- and third-degree), fibromyalgia, irritable bowel syndrome,  malaria, proctocolitis (inflammation of the rectum and colon), recurrent vulvovaginal candidiasis (yeast infection of the vagina and/or vulva, also called ‘thrush’), rheumatoid arthritis”

Again, why NHMRC reached this conclusion? Their answer: “For each condition, only one study that compared homeopathy with another treatment was found, and this study was unreliable. It was either poor quality (poorly designed or poorly done) or unknown quality, or it had too few participants to give a meaningful result, or both.”

Do not miss this very important observation by NHMRC: “The studies of homeopathy were generally poor quality. For some health conditions, this meant that no conclusion could be made on whether or not homeopathy was effective. For other conditions, this meant that NHMRC could not be confident that the results reported by studies were reliable.”

If available studies of homeopathy were generally of “poor quality”, and “no conclusion could be made” on the basis of those studies, how could NHMRC come to the generalized conclusion that “homeopathy is ineffective”?  If they “could not be confident” by available studies, how could be they so “confident” to give a sweeping verdict against homeopathy.  NHMRC is bound to explain this point.

NHMRC admits the LIMIATIONS of their study as follows:

“The overview was based on finding systematic reviews of homeopathy, rather than searching for all individual published studies of homeopathy. The advantage of this strategy was to make use of the large amount of work that had already been done by researchers around the world in finding and assessing studies and to provide an overarching picture of the whole body of evidence. However, there were also some disadvantages:

One of these systematic reviews reported significant publication bias, which the authors suggested was primarily due to under-reporting of studies with statistically non-significant effects and with negative effects. Clinical trial registries (included the World Health Organisation Clinical Trials Registry, the US government’s ClinicalTrials.gov and the Australian New Zealand Clinical Trials Registry) were searched but did not identify any extra studies.

Despite the above limitations, it is unlikely that a review of primary studies (rather than of systematic reviews) would have altered the findings. This is because the studies on homeopathy identified through this process were generally small and of poor quality (either poorly designed or poorly done). Due to the poor quality of the evidence base, the Homeopathy Working Committee had to apply caution when considering the results reported by studies. For some health conditions, this meant that no conclusion could be made on whether or not homeopathy was effective. For other conditions, this meant that NHMRC could not be confident that the results reported by studies were reliable.”

Let us sum up an abstract of the “limitations” NHMRC themselves identified in their methodology:

 All these are limitations of serious concern, which should have been properly attended and appropriately rectified before making any further “assessments” about homeopathy. Instead, NHMRC chose the comfort of ignoring these limitations by a sweeping remark: “Despite the above limitations, it is unlikely that a review of primary studies, rather than of systematic reviews would have altered the findings.”. They were so sure that nothing would alter their findings, as the ‘findings’ and ‘conclusions’ were pre-determined!