Asking the right questions is important in homoeopathic clinical research

Identifying the ‘right’ questions for clinical research in homoeopathy requires optimally defined objective. According to the author of this paper, in the current scenario, the main focus homoeopathic clinical research must be on randomised controlled trials (RCTs). Because, despite reservations about their application to homoeopathy research in the past, they are the only available way to prove cause and effect of an intervention. Many commentators, however, have failed to distinguish between the findings of placebo and other-than-placebo (OTP) controlled trials, while the individualised style of the normal homoeopathic intervention and the main effects anticipated from that intervention have not always been properly reflected. Thus, the interpretation of findings in terms of ‘efficacy’ or ‘effectiveness’ of the intervention is often unclear. Our method of ‘vote counting’ the results of RCTs in homoeopathy has enabled a clear categorisation of the research evidence, together with an opportunity to reflect condition-specific findings. That approach is not without flaws, however, and a more appropriate and sophisticated systematic review (SR) of the RCT evidence would be additionally helpful. Previous SRs of RCTs in homoeopathy have typically failed to provide clear conclusions about the effectiveness of homoeopathy as a system of medicine or about the efficacy of particular medicines. This is largely the result of a failure to distinguish: individualised from non-individualised homoeopathy; treatment from prophylaxis; and internal validity (risk of bias) from model validity (‘state of the art’ practice and relevant outcome measures). And SRs have paid little attention to the potency of the homoeopathic medicines used, to reviewing OTP-controlled RCTs, or to distinguishing between research published in the peer-reviewed and the non-peer-reviewed literature. A clearer and more complete awareness of the current RCT evidence will emerge from the above SR programme, which is now in progress. Importantly, the attributes of homoeopathy and study design that it addresses can be fully reflected in answering the key questions that are then applied to new RCTs in homoeopathy.

Reference: Robert T Mathie, Clinical research in homeopathy: asking the right questions, International Journal of High Dilution Research, Vol 11, No 40 (2012)

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