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NHMRC Draft Information Paper: Evidence on the effectiveness of homeopathy for treating health conditions submission

ID: 
15
This submission reflects the views of
Organisation Name: 
Home Economics Institute of Australia
Please identify the best term to describe the Organisation: 
Consumer organisation
Personal Details
Questions
Q1. Is the draft Information Paper presented and written in a manner that is easy to understand?: 

Preface

The mission of the home economics profession in Australia is to educate, inform, and act as an advocate to government, industry and the community for families and households, so that individuals can make informed choices in order to enhance their everyday living.

As the peak professional body for home economics professionals in Australia, the Home Economics Institute of Australia Inc. (HEIA) represents the interests of home economists working in education, industry, community services, consumer affairs and family and household management. Our membership-base is currently comprised predominately of home economics teachers in secondary schools, where optimising health and wellbeing is a key component of their teaching.

HEIA appreciates the opportunity to provide feedback to the National Health and Medical Research Council (NHMRC) on the draft Information Paper on the effectiveness of homeopathy for treating health conditions. Ensuring consumers have access to current, reliable and easy to understand information on key issues that affect health and wellbeing is integral to the functions of the home economics profession.

HEIA’s submission addresses questions 1 and 2 posed by NHMRC, namely:

Q1. Is the draft Information Paper presented and written in a manner that is easy to understand?

Q2. Does the draft Information Paper clearly outline how the evidence was reviewed and interpreted by the Homeopathy Working Committee?

HEIA comments

Q1. Is the draft Information Paper presented and written in a manner that is easy to understand?

Target audience

NHMRC provides no clear guidance on the age/education level to which the paper is pitched, which is important for appropriately commenting on the ‘ease of understanding’ aspect of this question. The terms ‘non-technical language’ and ‘Australian community’ provide a little guidance on this issue.

As currently written, the Information Paper assumes a moderate level of education is held by the reader. For this paper, HEIA supports the level to which it is pitched; however, it links to the need for a shortened summary of NHMRC’s findings and position on the use of homeopathy. HEIA understands that a NHMRC Position Statement is to be developed, which is only made evident in the diagram on page 8 of the Information Paper. The fact that the Information Paper will be supported by a shortened Position Statement needs to be made clearer.

Overall finding

To assist with ease of understanding of the overall finding of the review, HEIA suggests re-wording the statement from:

“The assessment of the evidence from research in humans does not show that homeopathy is effective for treating the range of health conditions considered”

to:

“There is no evidence from research in humans that homeopathy is effective for treating the range of health conditions considered.”

HEIA considers the second statement much easier to process and more consumer friendly. The statement is similar to the first dot point provided in the overall summary on page 19 of the Information Paper and, therefore, appears to reflect the thinking of NHMRC on the research findings.

Definition of study quality

HEIA suggests a clearer overview is provided on what defines study quality. It is understood that the systematic reviews were assessed using the ‘Assessing the Methodological Quality of Systematic Reviews’ method. The description of ‘quality’ throughout the documents is, however, not consistent and a little unclear.

To highlight this point, on page 14, the second dot point in the second column uses the terms ‘good-quality’ and ‘well designed’ separately when in all other parts of the document, ‘well designed’ is a component of quality.

In addition, the use of the terms ‘well done’ and ‘poorly done’ when describing study quality are not useful (pages 11 and 12). These terms are so broad it is unclear what the key concerns are with the studies. Some better descriptors may be needed to describe what is meant by study quality. If ‘poorly designed’ continues to be used, this too may need to be described.

Definition: Alternative and complementary medicines

A definition of ‘alternative and complementary medicines’ is needed at the start of the Information Paper; rather than being at the end in the ‘definitions’ section. They are important terms; the definition of which needs to be made up front. In addition, HEIA queries the definition given as it doesn’t pick up on the fact that complementary medicine is used in conjunction with conventional medicine, while alternative medicine is used in isolation.

Benefits and risks of homeopathy

The paper talks about the need for consumers and health professionals to be aware of the potential benefits and risks of homeopathy (p4). These are not made clear in the document other than the overall finding of the review that there is no evidence of the effectiveness of homeopathy. HEIA suggests that a short summary is included to cover this point. If there are no benefits, this needs to be made clear along with the risks. This may be something that is included in the Position Statement; however, they need to also be specified in this Information Paper.

Recommendations:

HEIA recommends that:

  • NHMRC makes it clearer that the Information Paper will be supported by a shortened Position Statement.
  • The overall finding is re-worded, to the suggested HEIA sentence, to assist with consumer comprehension.
  • The definition of ‘study quality’ is made clearer and consistently applied throughout the paper.
  • To assist with understanding the key issues in relation to homeopathy, the definition of ‘alternative and complementary medicines’ is provided at the start of the Information Paper.
  • The potential benefits and risks of homeopathy are outlined in the Information Paper, as these terms are used throughout. If there are no benefits, this needs to be made clear along with the risks.
Q2. Does the draft Information Paper clearly outline how the evidence was reviewed and interpreted by the Homeopathy Working Committee?: 

Q2. Does the draft Information Paper clearly outline how the evidence was reviewed and interpreted by the Homeopathy Working Committee?

The paper makes clear how the evidence was reviewed and interpreted by the Working Committee. The means by which the evidence was gathered is appropriately outlined, so too the method by which they were reviewed and the final outcome reached.

The paper also makes clear the importance of research studies as opposed to anecdotal evidence. Also clearly articulated is the design features of studies that carry the most weight in terms of providing reliable evidence.

Page reviewed: 11 March, 2015