You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series.
Abstract 1:
Abstract Objective : To test the hypothesis that homoeopathy is a placebo by examining its effect in patients with allergic rhinitis and so contest the evidence from three previous trials in this series . Design : R and omised , double blind , placebo controlled , parallel group , multicentre study . Setting : Four general practice s and a hospital ear , nose , and throat outpatient department . Participants : 51 patients with perennial allergic rhinitis . Intervention : R and om assignment to an oral 30c homoeopathic preparation of principal inhalant allergen or to placebo . Main outcome measures : Changes from baseline in nasal inspiratory peak flow and symptom visual analogue scale score over third and fourth weeks after r and omisation . Results : Fifty patients completed the study . The homoeopathy group had a significant objective improvement in nasal airflow compared with the placebo group ( mean difference 19.8 l/min , 95 % confidence interval 10.4 to 29.1 , P=0.0001 ) . Both groups reported improvement in symptoms , with patients taking homoeopathy reporting more improvement in all but one of the centres , which had more patients with aggravations . On average no significant difference between the groups was seen on visual analogue scale scores . Initial aggravations of rhinitis symptoms were more common with homoeopathy than placebo ( 7 ( 30 % ) v 2 ( 7 % ) , P=0.04 ) . Addition of these results to those of three previous trials ( n=253 ) showed a mean symptom reduction on visual analogue scores of 28 % ( 10.9 mm ) for homoeopathy compared with 3 % ( 1.1 mm ) for placebo ( 95 % confidence interval 4.2 to 15.4 , P=0.0007 ) . Conclusion : The objective results reinforce earlier evidence that homoeopathic dilutions differ from placebo


Title 2:
The long-term effects of homeopathic treatment of chronic headaches: one year follow-up and single case time series analysis.
Abstract 2:
Little is known about long-term effects of homeopathic treatment . Following a double-blind , placebo controlled trial of classical homeopathy in chronic headaches , we conducted a 1-year observational study of 18 patients following the double-blind phase , and a complete follow-up study of all trial participants . Eighteen patients received free treatment for daily diary data  ( frequency , intensity , duration of headaches ) over the course of 1 y. All patients enrolled in the double-blind study were sent a 6-week headache diary , a follow-up question naire , a personality inventory and a complaint list .  Eighty-seven , of the original 98 patients enrolled returned question naires , 81 returned diaries . There was no additional change from the end of the trial to the one-year follow-up . The improvement seen at the end of the 12-week trial was stable after 1 y. No differential effects according to treatment after the trial could be seen . Patients with no treatment following the trial had the most improvement after 1 y. Five of 18 patients can be counted responders according to ARIMA analysis of single-case time-series . Patients with double diagnoses and longer treatment duration tended to have clearer improvements than the rest of the patients . Approximately 30 % of patients in homeopathic treatment will benefit after 1 y of treatment . There is no indication of a specific , or of a delayed effect of homeopathy


Title 3:
Use of ultramolecular potencies of allergen to treat asthmatic people allergic to house dust mite: double blind randomised controlled clinical trial
Abstract 3:
Abstract Objective : To evaluate the efficacy of homoeopathic immunotherapy on lung function and respiratory symptoms in asthmatic people allergic to house dust mite . Design : Double blind r and omised controlled trial . Setting : 38 general practice s in Hampshire and Dorset . Participants : 242 people with asthma and positive results to skin prick test for house dust mite ; 202 completed clinic based assessment s , and 186 completed diary based assessment s. Intervention : After a four week baseline assessment , participants were r and omised to receive oral homoeopathic immunotherapy or placebo and then assessed over 16 weeks with three clinic visits and diary assessment s every other week . Outcome measure : Clinic based assessment s : forced expiratory volume in one second ( FEV1 ) , quality of life , and mood . Diary based assessment s : morning and evening peak expiratory flow , visual analogue scale of severity of asthma , quality of life , and daily mood . Results : There was no difference in most outcomes between placebo and homoeopathic immunotherapy . There was a different pattern of change over the trial for three of the diary assessment s : morning peak expiratory flow ( P=0.025 ) , visual analogue scale ( P=0.017 ) , and mood ( P=0.035 ) . At week three there was significant deterioration for visual analogue scale ( P=0.047 ) and mood ( P=0.013 ) in the homoeopathic immunotherapy group compared with the placebo group . Any improvement in participants ' asthma was independent of belief in complementary medicine . Conclusion : Homoeopathic immunotherapy is not effective in the treatment of patients with asthma . The different patterns of change between homoeopathic immunotherapy and placebo over the course of the study are unexplained


Title 4:
Homeopathic treatment of acute otitis media in children: a preliminary randomized placebo-controlled trial.
Abstract 4:
BACKGROUND The use of antibiotics in the initial treatment of acute otitis media is currently being question ed . Homeopathy has been used historically to treat this illness , but there have been no method ologically rigorous trials to determine whether there is a positive treatment effect . METHODS A r and omized double blind placebo control pilot study was conducted in a private pediatric practice in Seattle , WA . Seventy-five children ages 18 months to 6 years with middle ear effusion and ear pain and /or fever for no more than 36 h were entered into the study . Children received either an individualized homeopathic medicine or a placebo administered orally three times daily for 5 days , or until symptoms subsided , whichever occurred first . Outcome measures included the number of treatment failures after 5 days , 2 weeks and 6 weeks . Diary symptom scores during the first 3 days and middle ear effusion at 2 and 6 weeks after treatment were also evaluated . RESULTS There were fewer treatment failures in the group receiving homeopathy after 5 days , 2 weeks and 6 weeks , with differences of 11.4 , 18.4 and 19.9 % , respectively , but these differences were not statistically significant . Diary scores showed a significant decrease in symptoms at 24 and 64 h after treatment in favor of homeopathy ( P < 0.05 ) . Sample size calculations indicate that 243 children in each of 2 groups would be needed for significant results , based on 5-day failure rates . CONCLUSIONS These results suggest that a positive treatment effect of homeopathy when compared with placebo in acute otitis media can not be excluded and that a larger study is justified


Title 5:
Homeopathic prophylaxis of headaches and migraine? A systematic review.
Abstract 5:
Homeopathy is often advocated as a prophylaxis of  migraine and headaches .  The aim of this systematic review was to evaluate the clinical trials , testing the efficacy of homeopathy for these indications . Independent computerized literature search es were carried out in 4 data bases . Only r and omized , placebo-controlled trials were included . Four such studies were found . Their method ological quality was variable but , on average , satisfactory . One study suggested that homeopathic remedies were effective . The other , method ologically stronger trials did not support this notion . It is concluded that the trial data available to date do not suggest that homeopathy is effective in the prophylaxis of  migraine or headache  beyond a placebo effect


Title 6:
A randomized, controlled clinical trial of the homeopathic medication TRAUMEEL S in the treatment of chemotherapy-induced stomatitis in children undergoing stem cell transplantation.
Abstract 6:
BACKGROUND Stomatitis is a common consequence of chemotherapy and a condition for which there is little effective treatment . Although the management of patients with other chemotherapy-related toxicities has improved in recent years , the incidence of stomatitis is increasing because of more intensive treatment and is often a dose limiting factor in chemotherapy . The authors assessed the efficacy of a homeopathic remedy , TRAUMEEL S(R ) , in the management of chemotherapy-induced stomatitis in children undergoing bone marrow transplantation . METHODS A r and omized , placebo-controlled , double-blind clinical trial was conducted in 32 patients ages 3 - 25 years who had undergone allogeneic ( 16 patients ) or autologous ( 16 patients ) stem cell transplantation . Of the 30 evaluable patients , 15 were assigned placebo , and 15 were assigned TRAUMEEL S both as a mouth rinse , administered five times daily from 2 days after transplantation for a minimum of 14 days , or until at least 2 days after all signs of stomatitis  were absent . Stomatitis scores were evaluated according to the World Health Organization grading system for mucositis . RESULTS A total of five patients ( 33 % ) in the TRAUMEEL S treatment group did not develop stomatitis compared with only one patient ( 7 % ) in the placebo group . Stomatitis worsened in only 7 patients ( 47 % ) in the TRAUMEEL S treatment group compared with 14 patients ( 93 % ) in the placebo group . The mean area under the curve stomatitis scores were 10.4 in the TRAUMEEL S treatment group and 24.3 in the placebo group . This difference was statistically significant ( P < 0.01 ) . CONCLUSIONS This study indicates that TRAUMEEL S may reduce significantly the severity and duration of chemotherapy-induced stomatitis in children undergoing bone marrow transplantation


Title 7:
Homeopathy and conventional medicine: an outcomes study comparing effectiveness in a primary care setting.
Abstract 7:
BACKGROUND Recent meta-analyses of r and omized controlled trials in homeopathy have suggested that homeopathy is more than a placebo response . OBJECTIVE Comparison of the effectiveness of homeopathy in primary care with conventional medicine in primary care for three commonly encountered clinical conditions . DESIGN An international multicenter , prospect i ve , observational study in a real world medical setting comparing the effectiveness of homeopathy with conventional medicine . PARTICIPANTS Thirty ( 30 ) investigators with conventional medical licenses at six clinical sites in four countries enrolled 500 consecutive patients with at least one of the following three complaints : ( 1 ) upper respiratory tract complaints including allergies ; ( 2 ) lower respiratory tract complaints including allergies ; or ( 3 ) ear complaints . MAIN OUTCOME MEASURES The primary outcomes criterion was the response to treatment , defined as cured or major improvement after 14 days of treatment . Secondary outcomes criteria were : ( 1 ) rate of recovery ; ( 2 ) occurrence of adverse events ; ( 3 ) patient satisfaction ; and ( 4 ) length of consultation . RESULTS Four hundred and fifty-six ( 456 ) patient visits were compared : 281 received homeopathy  , 175 received conventional medicine .  The response to treatment as measured by the primary outcomes criterion for patients receiving homeopathy was 82.6 % , for conventional medicine it was 68 % . Improvement in less than 1 day and in 1 to 3 days was noted in 67.3 % of the group receiving homeopathy and in 56.6 % of those receiving conventional medicine . The adverse events for those treated with conventional medicine was 22.3 % versus 7.8 % for those treated with homeopathy . Seventy-nine percent ( 79.0 % ) of patients treated with homeopathy were very satisfied and 65.1 % of patients treated with conventional , medicine were very satisfied . In both treatment groups 60 % of cases had consultations lasting between 5 and 15 minutes . CONCLUSIONS Homeopathy appeared to be at least as effective as conventional medical care in the treatment of patients with the three conditions studied
Collectively they failed to provide strong evidence in favour of homeopathy .
In particular , there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions .
Similarly , there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo .
It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice