här - nordiska homeopatförbundet

Transcription

här - nordiska homeopatförbundet
Vad anser ert parti om att ha/avskaffa 8 års åldersgräns när det gäller homeopatisk
behandling av barn?
Vad är det som motiverar en sådan åldersgräns?
Vi i Nordiska Homeopatförbundet (NHF) anser att sådan åldersgräns bör avskaffas och stödjer oss på den
forskning som idag finns om homeopati, dess effektivitet, säkerhet och behandling av barn i andra länder,
inklusive Danmark, Norge och Finland.
Forskning i homeopati har vuxit lavinartat. Den omfattar grundforskning, kliniska studier, metodologi, dess
mekanism (hur homeopati fungerar), långsiktiga och epidemiologiska effekter, säkerhet, ekonomi, samt
systematiska översikter, inklusive meta-analyser. Det finns forskning som klassificerar homeopati som
placebo. Forskning som visar motsatsen, dess effektivitet utöver placebo effekten, har dock ökat allt mer.
Under de senaste åren har det levererats vetenskapliga bevis som bekräftar homeopatins effektivitet in vivo,
vitro och silico,
Stöd för homeopati kommer allt mer från nyare forskningsområden som nanomedicin/-farmakologi,
cellbiologi, neurobiologi, (bio)informatik och fysik. Det senaste och kanske mest kända fallet är Luc
Montagniers forskning(1). Han fick Nobelpris i medicin 2008.
Homeopati har anklagats för att vara ovetenskaplig eller pseudovetenskaplig och att den förnekar naturvetenskap. Dessa påståenden är i sig ovetenskapliga. Det är ovetenskapligt att påstå att homeopati är
pseudovetenskap på grund av att dess verkningsmekanism är okänd. Mycket av det kontroversiella i
sammanhanget handlar om tolkningar baserade på olika trossystem och perceptioner. T. ex Rutten et al –
alla läkare och forskare – argumenterar att homeopati har tolkats fel och att de olika åsikterna om homeopati
kan komma att konvergera när man studerar ultra-höga dilutioner in vitro (2).
Vilka resultat forskningen visar med avseende på homeopatins effekter, beror på den tillämpade metodiken.
All kunskap och vetenskap ska utvärderas, tolkas och bedömas på dess egna villkor, utifrån dess filosofi,
teori och metodologi. Man kan t ex inte värdera en kvalitativ studie utifrån kvantitativa kriterier. Vilken
effekt homeopati har beror på hur den tillämpas, dvs hur man väljer medlet ( s k modellvaliditet). Fel valda
medel ger inga effekter; inte ens i stora mängder. Hur patienterna behandlas homeopatiskt innan man
genomför studien har betydelse för resultatet. Ur homeopatins synvinkel sker feltolkningar på grund av
felaktig uppläggning av studien. Detta har bland annat schweiziska forskare, Frei et al (3) i sina studier om
hyperaktiva barn påpekat. Deras forskning under ett decennium visar hur viktigt det är att välja det optimala
homeopatiska medlet (rätta medlet) i början och att användning av andra mediciner i samband med homeopatisk behandling påverkar studieresultatet i fel riktning. Studier i homeopati måste följa de homeopatiska
behandlingsprinciperna för att ge adekvata resultat.
I bilaga 1 refererar vi till några systematiska översiktstudier när det gäller homeopatins effektivitet, säkerhet
och behandling av barn. Översiktsstudier (som metaanalyser) kombinerar resultat från flera studier för att få
fram en övergripande trend. Bilagan innehåller också exempel på enskilda studier på barn. Alla dessa studier
bekräftar homeopatin.
Vi ser tacksamt fram emot ert svar med motivering senast den 15 juli 2014.
Vänliga hälsningar
Nordiska homeopatförbundet( Nhf)
genom styrelsen: ordförande Åsa Oja Hägglund, vice ordförande Karin Victorin, sekreterare Barbro Lundell, kassör
Berit Lecomte, övriga ledamöter Ingegerd Berggren, och Annika Mårtensson, suppleanter Eivor Englund Karlsson,
Helen Melander och Johanna Lindh. För vidare information se vår hemsida www.nhf-homeopati.se
e-post info@nhf-homeopati.se
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Nordiska Homeopatförbundet (NHF)
Nordiska Homeopatförbundet vill förstärka homeopaternas och därmed även patienternas position
kunskapsmässigt och organisatoriskt samt utveckla ämnet homeopati i ett större samhälleligt perspektiv. Vår
vision är utveckling i effektiv samverkan. Vi följer aktivt forskningen inom området. NHF grundades 2003
och organiserar välutbildade homeopater i såväl traditionell medicin som homeopati.
Referenser
(1)
Lue Montagnier, Jamal Aissa, Stéphanie Ferris, Jean Luc Montagnier, Calude Lavalle: Electromagnetic signals are
produced by adequous nanostructure derived from bacterial DNA sequencies, Interdisc Sci Com Sci (2009)81-90
(2)
Rutten L, Mathie RT, Risher P, Gossens M, van Wassenhoven M: Plausibility and evidence. The case of
homeopathy, Medicine Health Care Philosophy 2013, Aug 16(3).525-32
(3)
H Frei, A Thurneysen: Treatment for hyperactive children and methylphenidale compared in a family setting.
British Homeopathic Journal 2001:90(4): 183-8
H Frei, R Everts, K von Ammon, K Kaufmann, D Walter, S-F Shu Schmitz, M Collenberg, K Fuhrer, R Hassink, M
Steinlin, et al: Homeopathic treatment of children with attention deficit hyperactivity disorder: a randomized
double bind, placebo controlled crossover trial. European Journal of Pediatrics, Dec 2005, Volume 164, Issue 12,
pp 758-767
H Frei, K von Ammon, A Thurneysen: Treatment of hyperactive children. Increased efficiency through
modification of homeopathic diagnostic procedure. Homeopathy, July 2006, Volume 95, Issue 3, Pages 163-70
H Frei, R Everts, K von Ammon, F Kaufmann, D Walter, S-F Shu Schmitz, M Collenberg, M Steinlin, C Linn, A
Thurneysen: Randomized controlled trials of homeopathy in hyperactive children. Treatment procedure leads
to unconventional study design, Homeopathy 2007, 96:34-41
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Bilaga I
1. Homeopatins effektivitet
Robert Hahn: Homeopathy: Meta analysis of pooled clinical data. Forshende Komplementär Medizine
2013:30:376-381
Abstract
In the first decade of the evidence-based era, which began in the mid-1990s, meta-analyses were used to
scrutinize homeopathy for evidence of beneficial effects in medical conditions. In this review, meta-analyses
including pooled data from placebo-controlled clinical trials of homeopathy and the aftermath in the form of
debate articles were analyzed. In 1997 Klaus Linde and co-workers identified 89 clinical trials that showed
an overall odds ratio of 2.45 in favor of homeopathy over placebo. There was a trend toward smaller benefit
from studies of the highest quality, but the 10 trials with the highest Jadad score still showed homeopathy
had a statistically significant effect. These results challenged academics to perform alternative analyses that,
to demonstrate the lack of effect, relied on extensive exclusion of studies, often to the degree that conclusions were based on only 5-10% of the material, or on virtual data. The ultimate argument against homeopathy is the 'funnel plot' published by Aijing Shang's research group in 2005. However, the funnel plot is
flawed when applied to a mixture of diseases, because studies with expected strong treatments effects are,
for ethical reasons, powered lower than studies with expected weak or unclear treatment effects. To conclude that homeopathy lacks clinical effect, more than 90% of the available clinical trials had to be disregarded. Alternatively, flawed statistical methods had to be applied. Future meta-analyses should focus on the
use of homeopathy in specific diseases or groups of diseases instead of pooling data from all clinical trials.
Dr Gudrun Domhoff, Prof Peter Matthiessen: Swiss Health Technology Assesment (HTA) 2006, 234 pages.
Exhaustively reviews the clinical research in homeopathy, including a summary of 22 systematic reviews of clinical
trials, 20 of which show a positive direction of evidence for homeopathy. The study is commissioned by Switzerland
Federal Social Insurance Office (FSIO) a part of an overall evaluation of complementary and alternative medicine
Enligt författarna finns det tillräckligt med bevis för homeopatins preklinisk och klinisk effektivitet, för dess
säkerhet och ekonomi jämfört med konventionell medicin.
Kleijnen J, Knipschild P, Ter Riet G. Clinical trials of homoeopathy. British Medical Journal.
1991b;302:316-23
Of the 105 trials with interpretable results, 81 trials indicated positive results. Most studies showed results in favour of
homeopathy even among those randomized controlled trials that received high-quality ratings for randomization,
blinding, sample size, and other methodological criteria. They came to the following conclusion: "The amount of
positive evidence even among the best studies came as a surprise to us. Based on this evidence we would readily
accept that homeopathy can be efficacious, if only the mechanism of action were more plausible. The evidence
presented in this review would probably be sufficient for establishing homeopathy as a regular treatment for certain
indications".
Linde K, Clausius N, Ramirez G, et al. Are the clinical effects of homoeopathy placebo effects? A metaanalysis of placebo-controlled trials. Lancet 1997;350:834-43
Meta-analysis of 89 trials of homeopathic medicine versus placebo. Result: significantly in favour of homeopathy (OR
2,45 (95% CI 2,05-2,93)). This meta-analysis included 186 placebo-controlled studies of homeopathy published until
mid-1996, of which data for analysis could be extracted from 89. The overall odds ratio was 2.45 (95% confidence
intervals 2.05-2.93) in favour of homeopathy, which means that the chances that homeopathy would benefit the patient
were 2.45 times greater than placebo. When considering just those trials of high quality published in MEDLINE listed
journals, and with predefined primary outcome measures, the pooled odds ratio was 1.97 and significant. Even after
correction for publication bias the results remained significant. The main conclusion was that the results "were not
compatible with the hypothesis that the effects of homeopathy are completely due to
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placebo". If the result of new trials were to show no difference between homeopathy and placebo, we would have to
add 923 trials with no effect with 118 patients in each in order to balance the two.
.
Mathie, R. The Research Evidence Base for Homeopathy. British Homeopathic Association,2009
As of 2009, there have been 142 randomized, controlled trials published in peer-reviewed journals that compared
homeopathy with placebo. A recent study found that 63 of the 74 conclusive studies were positive for homeopathy and
11 were negative.
2. Homeopatins säkerhet
European Council of Classical Homeopathy: The safety of Homeopathy, January 2009
Dantes F, Rampes H: Do homeopathic medicine provoke adverse effects? A systematic review. Br
Homeopath Journal, 2000: 89:535-8
3. Homeopati och pediatrik
3.1 Systematiska översikter
Jacobs J, Jonas WB, Jimenez-Perez M, Crothers D. Homeopathy for childhood diarrhea: combined results
and metaanalysis from three randomized, controlled clinical trials. Pediatr Infect Dis J 2003; 22: 229–34
A meta-analysis published in Pediatric Infectious Diseases, a peer reviewed medical journal, examined three double
blind clinical trials of diarrhea in 242 children. The results were highly significant and showed that individualized
homeopathic treatment decreases the duration of childhood diarrhea.
Mathie, R. The research evidence base for homeopathy: a fresh assessment of the literature. Homeopathy
92: 84-91. 2003.
A systematic review of results from 93 substantive RCTs was carried out by Robert Mathie (2003). It concludes that
of the 35 different medical conditions covered by these trials the weight of evidence favors a positive treatment effect
in 8: childhood diarrhaea, fibrosis, hay fever, influenza, pain (miscellaneous), side-effects of chemotherapy or
radiotherapy, sprains and upper-respiratory tract infections.
3.2 Enstaka, kliniska studier
Alison Fixsen: Should homeopathy be considered as part of a treatment strategy for otitis media with effusion in children?
Homeopathy, Volume 102, Issue 2, Pages 145-150, April 2013
Elio Rossi, Paola Bartoli, Alba Bianchi, Monica DaFré. Homeopathy in paediatric atopic diseases; long term results in
Children with atopic dermatit. Homeopathy, Volume 101, Issue 1, Pages 13-20, January 2012
Nita M Ramchandan; Homeopathic treatment of upper respiratory tract infections in children: Evaluation of thirty case
series Complementary Therapies in Clinical Practice, Volume 16, Issue 2, Pages 101-108, May 2010
Alibeu JP1, Jobert J1 Département d'anesthésie-réanimation, CHU de Grenoble, France; Aconite in homeopathic relief of postoperative pain and agitation in children]. Pediatrie. 1990;45(7-8):465-6.
Homeopathic Treatment of Migraine in Children: Results of a Prospective, Multicenter, Observational Study. The Journal of
Alternative and Complementary Medicine. February 2013, 19(2): 119-123. doi:10.1089/acm.2011.0821.
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