http___matrixworldhr.wordpress.com_2012_07_16_izuzetno-pozitivno-izvjesce-svicarske-vlade-o-homeopatiji__1.xml
1.1 2.1 3.1 4.1 4.2 5.1 6.1 6.2 7.1 7.2 8.1 8.2 8.3 8.4 9.1 10.1 10.2 10.3 10.4 11.1 12.1 12.2 12.3 13.1 13.2 13.3 13.4 14.1 14.2 15.1 15.2 15.3 15.4 15.5 16.1 16.2 16.3 16.4 16.5 16.6 17.1 17.2 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 19.1 20.1 21.1
This breakthrough report not only affirms that homeopathic treatment is effective, cost-effective and safe – but also that homeopathic treatment should be reimbursed by Switzerland’s national health insurance programme. The most comprehensive governmental report ever written on Homeopathy looked at the evidence for Homeopathy from randomized double-blind and placebo controlled clinical trials – and (taking a true scientific approach to the subject) evaluated the scientific evidence from a wide body of preclinical research (fundamental physio-chemical research, botanical studies, animal studies, and in-vitro studies with human cells). They also took proper scientific account of the many systematic reviews and meta-analyses, outcome studies, and epidemiological research studies that have been undertaken. After assessing the pre-clinical basic research and high quality clinical studies, the Swiss report confirmed that homeopathic high-potencies seem to induce regulatory effects and specific changes in cells or living organisms. The report also said that 20 of the 22 systematic reviews of clinical research testing homeopathic medicines detected at least a trend in favour of homeopathy. Dana Ullman The Swiss government has a long and widely-respected history of neutrality, and therefore, reports from this government on controversial subjects need to be taken more seriously than other reports from countries that are more strongly influenced by present economic and political constituencies. When one considers that two of the top five largest drug companies in the world have their headquarters in Switzerland, one might assume that this country would have a heavy interest in and bias toward conventional medicine, but such assumptions would be wrong. In late 2011, the Swiss government’s report on homeopathic medicine represents the most comprehensive evaluation of homeopathic medicine ever written by a government and was just published in book form in English (Bornhoft and Matthiessen, 2011). This breakthrough report affirmed that homeopathic treatment is both effective and cost-effective and that homeopathic treatment should be reimbursed by Switzerland’s national health insurance program. The Swiss government’s inquiry into homeopathy and complementary and alternative (CAM) treatments resulted from the high demand and widespread use of alternatives to conventional medicine in Switzerland, not only from consumers but from physicians as well. Approximately half of the Swiss population have used CAM treatments and value them. Further, about half of Swiss physicians consider CAM treatments to be effective. Perhaps most significantly, 85 percent of the Swiss population wants CAM therapies to be a part of their country’s health insurance program. It is therefore not surprising that more than 50 percent of the Swiss population surveyed prefer a hospital that provides CAM treatments rather to one that is limited to conventional medical care. Beginning in 1998, the government of Switzerland decided to broaden its national health insurance to include certain complementary and alternative medicines, including homeopathic medicine, traditional Chinese medicine, herbal medicine, anthroposophic medicine, and neural therapy. This reimbursement was provisional while the Swiss government commissioned an extensive study on these treatments to determine if they were effective and cost-effective. The provisional reimbursement for these alternative treatments ended in 2005, but as a result of this new study, the Swiss government’s health insurance program once again began to reimburse for homeopathy and select alternative treatments. In fact, as a result of a national referendum in which more than two-thirds of voters supported the inclusion of homeopathic and select alternative medicines in Switzerland’s national health care insurance program, the field of complementary and alternative medicine has become a part of this government’s constitution (Dacey, 2009; Rist, Schwabl, 2009). The Swiss Government’s “Health Technology Assessment” The Swiss government’s “Health Technology Assessment” on homeopathic medicine is much more comprehensive than any previous governmental report written on this subject to date. Not only did this report carefully and comprehensively review the body of evidence from randomized double-blind and placebo controlled clinical trials testing homeopathic medicines, they also evaluated the “real world effectiveness” as well as safety and cost-effectiveness. The report also conducted a highly-comprehensive review of the wide body of preclinical research (fundamental physio-chemical research, botanical studies, animal studies, and in vitro studies with human cells). And still further, this report evaluated systematic reviews and meta-analyses, outcome studies, and epidemiological research. This wide review carefully evaluated the studies conducted, both in terms of quality of design and execution (called “internal validity”) and how appropriate each was for the way that homeopathy is commonly practiced (called “external validity”). The subject of external validity is of special importance because some scientists and physicians conduct research on homeopathy with little or no understanding of this type of medicine (some studies tested a homeopathic medicine that is rarely used for the condition tested, while others utilized medicines not commonly indicated for specific patients). When such studies inevitably showed that the homeopathic medicine did not “work,” the real and accurate assessment must be that the studies were set up to disprove homeopathy… or simply, the study was an exploratory trial that sought to evaluate the results of a new treatment (exploratory trials of this nature are not meant to prove or disprove the system of homeopathy but only to evaluate that specific treatment for a person with a specific condition). After assessing pre-clinical basic research and the high quality clinical studies, the Swiss report affirmed that homeopathic high-potencies seem to induce regulatory effects (e.g., balancing or normalizing effects) and specific changes in cells or living organisms. The report also reported that 20 of the 22 systematic reviews of clinical research testing homeopathic medicines detected at least a trend in favor of homeopathy.* (Bornhöft, Wolf, von Ammon, et al, 2006) The Swiss report found a particularly strong body of evidence to support the homeopathic treatment of Upper Respiratory Tract Infections and Respiratory Allergies. The report cited 29 studies in “Upper Respiratory Tract Infections/AllergicReactions,” of which 24 studies found a positive result in favor of homeopathy. Further, six out of seven controlled studies that compared homeopathic treatment with conventional medical treatment showed that homeopathy to be more effective than conventional medical interventions (the one other trial found homeopathic treatment to be equivalent to conventional medical treatment). All of these results from homeopathic treatment came without the side effects common to conventional drug treatment. In evaluating only the randomized placebo controlled trials, 12 out of 16 studies showed a positive result in favor of homeopathy. The authors of the Swiss government’s report acknowledge that a part of the overall review of research included one review of clinical research in homeopathy (Shang, et al, 2005). However, the authors noted that this review of research has been widely and harshly criticized by both advocates and non-advocates of homeopathy. The Swiss report noted that the Shang team did not even adhere to the QUORUM guidelines which are widely recognized standards for scientific reporting (Linde, Jonas, 2005). The Shang team initially evaluated 110 homeopathic clinical trials and then sought to compare them with a matching 110 conventional medical trials. Shang and his team determined that there were 22 “high quality” homeopathic studies but only nine “high quality” conventional medical studies. Rather than compare these high quality trials (which would have shown a positive result for homeopathy), the Shang team created criteria to ignore a majority of high quality homeopathic studies, thereby trumping up support for their original hypothesis and bias that homeopathic medicines may not be effective (Lüdtke, Rutten, 2008). The Swiss report also notes that David Sackett, M.D., the Canadian physician who is widely considered to be one of the leading pioneers in “evidence based medicine,” has expressed serious concern about those researchers and physicians who consider randomized and double-blind trials as the only means to determine whether a treatment is effective or not. To make this assertion, one would have to acknowledge that virtually all surgical procedures were “unscientific” or “unproven” because so few have undergone randomized double-blind trials. About author : DANA ULLMAN, MPH, is one of America’s leading advocates for homeopathy. He has authored 10 books, including The Homeopathic Revolution: Why Famous People and Cultural Heroes Choose Homeopathy, Homeopathy A-Z, Homeopathic Medicines for Children and Infants, Discovering Homeopathy, and (the best-selling) Everybody’s Guide to Homeopathic Medicines (with Stephen Cummings, MD). Dana also authored an ebook that is a continually growing resource to 200+ clinical studies published in peer-review medical journals testing homeopathic medicines. This ebook combines the descriptions of these studies with practical clinical information on how to use homeopathic medicines for 100+ common ailments. This ebook is entitled Homeopathic Family Medicine: Evidence Based Nano-pharmacology, and it is an invaluable resource. He is the founder of Homeopathic Educational Services, America’s leading resource center for homeopathic books, tapes, medicines, software, and correspondence courses. Homeopathic Educational Services has co-published over 35 books on homeopathy with North Atlantic Books. Dana writes a regular column for the wildly popular website, www.huffingtonpost.com (to access these articles, click HERE!) Read more : http://www.huffingtonpost.com/dana-ullman/homeopathic-medicine-_b_1258607.html Read Original Report online : http://www.springerlink.com/content/978-3-642-20638-2#section=949782&page=4&locus=24 Copies of the report can be purchased from the web-site: http://www.springer.com/medicine/complementary+%26+alternative+medicine/book/978-3-642-20637-5.
1.1 2.1 3.1 3.2 4.1 4.2 5.1 5.2 5.3 5.4 6.1 7.1 7.2 7.3 7.4 8.1 8.2 8.3 9.1 9.2 9.3 10.1 11.1 11.2 12.1 12.2 12.3 12.4 12.5 13.1 13.2 13.3 13.4 13.5 13.6 14.1 14.2 15.1 16.1
Prevela i uredila: Irena Dujmušić Matrix World Krajem 2011, švicarska vlada objavila je najobimnije vrednovanje homeopatskog liječenja ikad napisano od strane vlasti i objavljeno je u obliku knjige na engleskom jeziku. Ovo revolucionarno izvješće potvrđuje da je homeopatski tretman učinkovit i isplativ te da bi ovaj način liječenja trebao biti sufinanciran i od strane švicarskog programa nacionalnog zdravstvenog osiguranja. Vlada Švicarske ima dugu povijest neutralnosti, stoga ovo izvješće vlade o kontroverznim temama treba uzeti ozbiljnije od drugih izvješća iz zemalja koje su pod snažnijim ekonomskim i političkim utjecajem. Nadalje, kada se uzme u obzir da dvije od pet najvećih farmaceutskih tvrtki u svijetu imaju svoje sjedište u Švicarskoj, moglo bi se pretpostaviti da će ova zemlja imati interes i sklonosti prema konvencionalnoj medicini, no ovaj izvještaj potvrđuje upravo suprotno. Istraga švicarske vlade o homeopatiji i komplementarnim i alternativnim (CAM) tretmanima posljedica je velike potražnje i raširene uporabe alternativa konvencionalnoj medicini u Švicarskoj, i to ne samo pacijenata već i liječnika. Otprilike polovica švicarske populacije koristi CAM tretmane i donosi ocjenu o njihovoj vrijednosti. Nadalje, oko polovice švicarskih liječnika smatra da su CAM tretmani učinkoviti. Možda najvažnije, 85 posto švicarskog stanovništva želi da CAM terapije budu dio programa zdravstvenog osiguranja njihove zemlje. Stoga ne čudi da više od 50 posto ispitanika švicarske populacije radije izabire bolnicu koja pruža CAM tretmane, od one koja je ograničena na konvencionalnu medicinsku njegu. Počevši od 1998, vlada u Švicarskoj je odlučila proširiti svoje nacionalno zdravstveno osiguranje uključivanjem određenog komplementarnog i alternativnog liječenja, uključujući homeopatsku medicinu, tradicionalnu kinesku medicinu, biljnu medicinu, antropozofičnu medicinu i neuralne terapije. Ovo je bila samo privremena odluka dok je Švicarska vlada čekala rezultate naručene opsežne studije o tim tretmanima kako bi se utvrdilo da li su učinkoviti i ekonomični. Privremena naknada za ove alternativne tretmane završila je 2005., ali kao rezultat ove nove studije, švicarski Vladin program za zdravstveno osiguranje ponovno je počeo odobravati homeopatiju i alternativne tretmane. U stvari, kao rezultat nacionalnog referenduma u kojem je više od dvije trećine birača podržalo uključivanje homeopatskih i određenih alternativnih liječenja u program švicarskog nacionalnog zdravstvenog osiguranja, područje komplementarne i alternativne medicine postalo je dio ustava ove vlade. Zdravstveno tehnološka procjena švicarske vlade o homeopatskom liječenju je mnogo obuhvatnija od bilo kojeg prethodnog pisanog izvješća od strane vlade na tu temu do danas. Ovo izvješće pažljivo i sveobuhvatno pregledava dokaze iz dvostruko slijepih i placebo kontroliranih kliničkih ispitivanja testiranja homeopatskih lijekova, također su ocijenili “stvarnu učinkovitost”, kao i sigurnost i isplativost. U izvješću se također provodi visoko-cjelovit pregled predkliničkih istraživanja (temeljna fizikalno-kemijska istraživanja, botaničke studije, istraživanja na životinjama, te in vitro studije s ljudskim stanicama). I nadalje, ovo izvješće ocjenjuje sustavne izvještaje i meta-analize, ishode studija, kao i epidemiološka istraživanja. Ovaj široki pregled pažljivo vrednuje provedena istraživanja, kako u pogledu kvalitete dizajna i izvedbe pod nazivom “unutarnja valjanost” te prikladnost načina kako se homeopatija obično prakticira, “eksterna valjanost”. Predmet vanjske valjanosti je od posebnog značaja, jer su neki znanstvenici i liječnici provodili istraživanje o homeopatiji s malo ili nimalo razumijevanja za ovu vrstu liječenja (u nekim studijma testirani su homeopatski lijekovi koji se rijetko koriste za stanje testiranja, a drugi lijekovi se obično ne koriste za pojedine bolesnike). Kada takve studije neminovno pokažu da ne rade, stvarna i točna procjena mora biti da su studije postavljene da diskreditiraju homeopatiju … ili jednostavno, studija je istraživački postupak koji vrednuje rezultate novog tretmana (istraživački postupci ovakve prirode ne bi trebali dokazati ili opovrgnuti sustav homeopatije, nego samo vrednovati određeni tretman za osobe s posebnim stanjima). Nakon procjena pred-kliničkih temeljnih istraživanja i kliničkih studija visoke kvalitete, švicarsko izvješće potvrdilo je da homeopatski visoki potencijal potiče regulatorne učinke (npr. balansirajuće ili normalizacijske učinke) i određene promjene u stanicama ili živim organizmima. U izvješću se također navodi da su 20 od 22 sustavnih pregleda kliničkih istraživanja homeopatskih liječenja otkrili barem naklonjenost u korist homeopatije. Švicarsko izvješće posebno je istaklo snažne dokaze za homeopatsko liječenje gornjih respiratornih infekcija i respiratornih alergija. Izvješće navodi 29 studija “infekcija gornjih dišnih puteva / alergijskih reakcija”, od kojih je 24 studije pokazalo pozitivan rezultat u korist homeopatije. Nadalje, šest od sedam kontroliranih studija homeopatskog tretmana, u usporedbi s konvencionalnim tretmanom liječenja, pokazalo je da je homeopatija učinkovitija od konvencionalnih medicinskih intervencija (jedna druga studija nalazi da je homeopatski tretman jednak konvencionalnom liječenju). Svi ovi rezultati homeopatskog liječenja dolaze bez nuspojava koje su zajedničke konvencionalnim liječenjima. U procjeni nasumičnih placebo kontroliranih ispitivanja, 12 od 16 studija pokazalo je pozitivan rezultat u korist homeopatije. Autori švicarskog izvješća potvrđuju da dio ukupnog pregleda istraživanja uključuju jednu negativnu ocjenu kliničkih istraživanja u homeopatiji (Shang, et al, 2005). Međutim, autori napominju da je ovaj pregled istraživanja široko i oštro kritiziran od strane zagovornika i protivnika homeopatije. Shangov tim nije ni u skladu s QUORUM smjernicama koje su široko priznati standardi znanstvenog izvještavanja. Ovaj tim je inicijalno je procjenjivao 110 homeopatskih kliničkih ispitivanja, a zatim ih je pokušao usporediti s odgovarajućih 110 konvencionalnih medicinskih ispitivanja. Utvrdili su da su 22 homeopatske studije “visoke kvalitete”, ali samo devet konvencionalnih medicinskih studija “visoke kvalitete”. Umjesto da usporede ove studije visokih kvaliteta (koje bi pokazale pozitivan rezultat za homeopatiju), Shangov tim stvorio je kriterije koji zanemaruju većinu kvalitetnih homeopatskih istraživanja, čime poništavaju potporu svojoj izvornoj hipotezi i potiču predrasude da homeopatsko liječenje možda nije efektivno. Švicarsko izvješće također navodi da je David Sackett, kanadski liječnik koji se naširoko smatra jednim od vodećih pionira u “medicini temeljenoj na dokazima”, izrazio ozbiljnu zabrinutost o znanstvenicima i liječnicima koji uzimaju u obzir nasumične i dvostruko slijepe pokuse, samo da bi utvrdili da li je liječenje učinkovito ili ne. Ta bi tvrdnja onda morala značiti da su gotovo svi kirurški zahvati bili “neznanstveni” ili “nedokazani”, jer ih je premalo prošlo kroz dvostruko slijepe studije. Da bi se za liječenje odredilo da je “efektivno ” ili “znanstveno dokazano”, zahtjeva mnoge sveobuhvatne procjene. U konačnici, švicarsko vladino izvješće o homeopatiji predstavlja ocjenu homeopatije koje uključuje procjenu dvostruko slijepih ispitivanja, kao i druge dokaze, što sve zajedno utvrđuje da je homeopatsko liječenje zaista učinkovito.