HRI Online 2022: Leading International Experts Illustrate the Positive Impact of Increased Collaboration in Homeopathy Research.

The Homeopathy Research Institute (HRI) welcomed more than 450 people from 35 countries to their first online event on June 25, 2022. The one-day programme featured an excellent line-up of international speakers and provided a unique interactive platform in keeping with the theme of the event - Key Collaborations in Homeopathy Research. Scientists from a range of different research fields gave an exceptional insight into the current status of homeopathy research. Here we give an overview of the most significant findings in both clinical and basic research presented during HRI Online 2022.

Data Collection during the COVID-19 Pandemic: Learning from Experience, Resulting in a Bayesian Repertory.

BACKGROUND: A novel pandemic disease offered the opportunity to create new, disease-specific, symptom rubrics for the homeopathic repertory. OBJECTIVE: The aim of this study was to discover the relationship between specific symptoms and specific medicines, especially of symptoms occurring frequently in this disease. MATERIALS AND METHODS: Worldwide collection of data in all possible formats by various parties was coordinated by the Liga Medicorum Homeopathica Internationalis. As the data came in, more symptoms were assessed prospectively. Frequent analysis and feedback by electronic newsletters were used to improve the quality of the data. Likelihood ratios (LRs) of symptoms were calculated. An algorithm for combining symptom LRs was programmed and published in the form of an app. The app was tested against 18 well-described successful cases from Hong Kong. RESULTS: LRs of common symptoms such as 'Fatigue' and 'Headache' provided better differentiation between medicines than did existing repertory entries, which are based only on the narrow presence or absence of symptoms. A mini-repertory for COVID-19 symptoms was published and supported by a web-based algorithm. With a choice of 20 common symptoms, this algorithm produced the same outcome as a full homeopathic analysis based upon a larger number of symptoms, including some that are traditionally considered more specific to particular medicines. CONCLUSION: A repertory based on clinical data and LRs can differentiate between homeopathic medicines using a limited number of frequently occurring epidemic symptoms. A Bayesian computer algorithm to combine symptoms can complement a full homeopathic analysis of cases.

Prevalence and Likelihood Ratio of Six Objective Signs among Good Responders to Natrum muriaticum: Multi-centre Observational Assessment.

BACKGROUND: The reliability of homeopathic prescriptions may increase through resource to objective signs and guiding symptoms with significant positive likelihood ratio (LR). We estimated LR for six objective signs attributed to the homeopathic medicine Natrum muriaticum (Nat-m). METHODS: In this multi-centre observational assessment, we investigated the prevalence of six signs in the general patient population and among good responders to Nat-m in daily homeopathic practice. Next, we calculated LR for these six signs. RESULTS: Data from 36 good responders to Nat-m and 836 general population patients were compared. We found statistically significant positive LR (95% confidence interval) for signs such as lip cracks (1.94; 1.15 to 3.24), recurrent herpes (2.29; 1.20 to 4.37), hairline eruptions (2.07; 1.03 to 4.18), and dry hands (2.13; 1.23 to 3.69). CONCLUSIONS: Objective signs with significant positive LR might increase the reliability of homeopathic prescriptions. Further studies are warranted to confirm the validity of this approach.

Counting Polar Symptoms: How to Represent Results?

BACKGROUND: Polar symptoms (PS)-symptoms with opposite values-are frequently used in homeopathy, but have many misleading entries in the repertory. This is caused by using absolute occurrence of symptoms, causing the same medicine to appear in both (opposite) symptom rubrics, and by lack of comparison with other medicines. Some PS, like 'aversion/desire for sweets' have a frequency distribution that is not evenly distributed around the neutral value: a desire for sweets is much more common than aversion. A desire for sweets is an indication for a specific medicine only if this desire occurs more frequently in this specific medicine population than in the remainder of the population. We need to find the best way to represent this difference. METHODS: A multi-centre, explorative, prospective, observational study was conducted by nine centres of the Central Council for Research in Homoeopathy. Two-hundred and sixteen patients were enrolled with chronic cough lasting more than 8 weeks, and received usual homeopathic care. During intake, 30 general PS, 27 polar cough symptoms and 3 non-polar cough symptoms were checked. Different ways of representing results were explored, including two quantities borrowed from mechanics: Centre of Mass (CoM) and Leverage. RESULTS: At the fourth follow-up, three medicines with more than 10 cases with good results were identified: 20 Phosphorus, 19 Pulsatilla and 13 Sulphur. The mean value of the frequency distribution of some symptoms in the whole sample was considerably different from the neutral value. Comparing a medicine population with the remainder of the respective population can give results that differ from polarity analysis. For some symptoms, the 'distance' (Leverage) between the CoMs of the medicine population and the remainder of the population was clearer than the likelihood ratio (LR). CONCLUSION: If the LR value is not clear about the prognostic value in PS, notions from mechanics such as CoM and Leverage can clarify how to interpret a polar symptom.

Convém ser cético de alguns céticos / Some skeptics should be skeptical

Todo homeopata consciente tem hoje uma preocupação fundamental: desvendar o praticamente desconhecido mecanismo de ação do medicamento homeopático. Precisamos entender a sua ação. Necessitamos comprovar ­ para os não homeopatas ­ a sua eficácia. Necessitamos fornecer bases científicas para a interpretação do seu mecanismo de ação, não só para satisfazermos a nossa ânsia de melhor entendermos a homeopatia como um todo, mas também de conhecermos o medicamento, como parte, e ainda com a finalidade de nos munirmos com armas suficientes, quali e quantitativamente, a fim de evitarmos as campanhas desenvolvidas, vez por outra, pelos detratores da homeopatia que procuram destruí-la, impingindo-lhe rótulos tais como efeito placebo, efeito psicológico, não científica ou mesmo charlatanice.

Model validity of randomised placebo-controlled trials of non-individualised homeopathic treatment.

BACKGROUND: The comprehensive systematic review of randomised placebo-controlled trials (RCTs) in homeopathy requires examination of a study's model validity of homeopathic treatment (MVHT) as well as its risk of bias (extent of reliable evidence). OBJECTIVE: To appraise MVHT in those RCTs of non-individualised homeopathy that an associated investigation had judged as 'not at high risk of bias'. DESIGN: Systematic review. METHODS: An assessment of MVHT was ascribed to each of 26 eligible RCTs. Another 49 RCTs were ineligible due to their high risk of bias. MAIN OUTCOME MEASURES: MVHT and the prior risk of bias rating per trial were merged to obtain a single overall quality designation ('high', 'moderate', 'low'), based on the GRADE principle of downgrading. RESULTS: The trials were rated as 'acceptable MVHT' (N = 9), 'uncertain MVHT' (N = 10) and 'inadequate MVHT' (N = 7); and, previously, as 'reliable evidence' (N = 3) and 'non-reliable evidence' (N = 23). The 26 trials were designated overall as: 'high quality' (N = 1); 'moderate quality' (N = 18); 'low quality' (N = 7). CONCLUSION: Of the 26 RCTs of non-individualised homeopathy that were judged 'not at high risk of bias', nine have been rated 'acceptable MVHT'. One of those nine studies was designated 'high quality' overall ('acceptable MVHT' and 'reliable evidence'), and is thus currently the only reported RCT that represents best therapeutic practice as well as unbiased evidence in non-individualised homeopathy. As well as minimising risk of bias, new RCTs in this area must aim to maximise MVHT and clarity of reporting.

What do homeopathic doctors think of vaccines? An international online survey.

BACKGROUND AND OBJECTIVES: Parental refusal to vaccinate is a cause of serious concern. Use of homeopathy is believed to be a relevant reason for parents to refuse to vaccinate. However, vaccination is one of the main gaps dividing between medically qualified or not homeopathic practitioners. The present study sought to investigate the attitude of homeopathic doctors towards vaccination and associated variables. METHODS: An international online survey was conducted with homeopathic doctors by means of an anonymous self-reported questionnaire in Portuguese or Spanish. Questions investigated sociodemographic and professional characteristics, overall opinion on vaccination and on some specific vaccines. RESULTS: A total of 512 responses were obtained, 77.5% of respondents were from Latin American countries, 16.8% from Spain, with small numbers from several other countries. About 75.6% of the respondents considered vaccination safe, effective and necessary, while 12.5% stated they would not recommend vaccination under any circumstance. The variables significantly correlated with positive attitude towards vaccination were: working in the public health system (p=0.04) and homeopathy not the main medical activity (p=0.005). Homeopaths from Brazil, where homeopathy is officially accredited, were more favorable to vaccination compared to respondents from countries where homeopathy has inferior status (p<0.001). CONCLUSION: The results show that there is no contradiction between homeopathy and primary prevention by means of vaccination.

Prevalence and likelihood ratio of symptoms in patients with good therapeutic response to Lycopodium clavatum. A retrospective study.

BACKGROUND: Assessment of the likelihood ratio (LR) of symptoms has been proposed as a rational means for detecting indicators to homeopathic medicines. AIMS: To investigate the prevalence and LR of symptoms commonly attributed to the homeopathic medicine Lycopodium clavatum (Lyc). Secondarily, to answer the question if experienced homeopaths could intuitively infer which the main symptoms of this medicine are. METHODS: The presence of 35 selected symptoms, prescribed medicines and therapeutic response were assessed retrospectively. The symptoms' prevalence in the Lyc responding population and the LR of the symptoms compared to their prevalence in the remainder of the population were calculated. RESULTS: Two hundred and two Lyc and 550 non Lyc cases (total 752) were included for analysis. Twenty-two symptoms were confirmed as pertaining to Lyc's semiology (prevalence %; LR): contemptuous (3.3; 6.7), urinary stones history (2.7; 5.4), egotism (5.6; 3.6), dictatorial (33.3; 3.4), haughty (8.7; 3.3), sleeps on abdomen (3.3; 3.3), intolerance to clothing in abdomen (12.0; 3.1), reproaches (4.0; 3.0), helplessness (24.0; 2.7), fear of failure (10.7; 2.6), irritability on waking in the morning (16.7; 2.5), constipation alternating with diarrhea (8.7; 2.5), intolerant to contradiction (59.3; 2.3), want of self confidence (30.0; 2.4), abdominal distension after eating (23.3; 2.1); ailments from anticipation (32.0; 1.9), irritability before menses (23.3; 1.8), conscientious (26.0; 1.6), desire of sweets (52.0; 1.6), desire of chocolate (16.7; 1.6), lack of vital heat (41.3; 1.3), and flatterer (1.3; ∞). Surveyed homeopaths' intuitive inferences correlated well with symptoms' prevalence but not with their LR. CONCLUSIONS: Lycopodium's main symptoms are well known by homeopaths, but their knowledge correlates well with the symptoms' prevalence and not with their LR. Retrospective assessment of prevalence and LR of symptoms in good responders might be a means for better selection of symptoms for prospective studies.

The Lancet e o proclamado fim da homeopatia: revisão crítica da publicaçãode Shang et al (2005) e dos artigos relacionados subsequentes / The Lancet and the announced end of homeopathy: critical review of Shang et al’s (2005) study and subsequent related articles

Em agosto de 2005, The Lancet publicou uma metanálise comparativa de estudosclínicos homeopáticos e estudos clínicos convencionais que, de acordo com osautores, demonstrava que a homeopatia é placebo. Essa publicação teve grandeimpacto na mídia e na literatura médica. O objetivo do presente trabalho foi realizaruma crítica dessa publicação e uma revisão das publicações relacionadassubsequentes. Os resultados mostram que o trabalho de Shang et al apresenta viésgrave de seleção, viés de análise e, possivelmente, também viés de análise post hocque invalidam suas conclusões. O pano de fundo político pode ter exercido influênciasubstancial nos resultados. Os ensaios clínicos homeopáticos analisados tiverammelhor qualidade metodológica que os convencionais, sendo que a maioria teveresultado terapêutico positivo.

In August 2005, The Lancet published a meta-analysis comparing homeopathic andconventional clinical studies that according to its authors showed homeopathy to be aplacebo effect. That article exerted strong impact on the overall media and the medicalliterature. The aim of the present study was to perform a critical appraisal of that metaanalysis,and a review of the subsequent related publications. The results show that thestudy by Shang et al exhibits severe selection bias, analysis bias, and possibly also posthoc analysis bias, which make its conclusions invalid. Political background factorsmight have exerted substantial influence on the results. The analyzed homeopathicclinical studies exhibited better methodological quality compared to the conventionalones, and most had positive therapeutic results.

En agosto de 2005 The Lancet publicó un metanálisis comparativo de ensayos clínicosde homeopatía y ensayos clínicos convencionales que, de acuerdo a sus autores, llegaa la conclusión de que la homeopatía es placebo. Este tuvo un impacto muy elevadoen los medios y la bibliografía médica. El objetivo de este trabajo es hacer una críticade esta publicación y una revisión de las publicaciones relacionadas que le siguieron.Conclusiones: la investigación de Shang et al adolece de serios sesgos de selección delos trabajos, sesgos de análisis y probablemente de análisis post hoc que invalidan susconclusiones. El trasfondo político podría haber tenido una influencia sustancial en losresultados. Los ensayos clínicos homeopáticos son de mejor calidad metodológica quelos convencionales y la mayoría de ellos dan un resultado terapéutico positivo.

Ulcera varicosa de miembro inferior: relato de un caso clínico tratado con homeopatía / Tratamento homeopático de úlcera varicosa: relato de caso / Homeopathic treatment of venous ulcer: case report

El artículo relata el caso de una mujer de 86 años, con una extensa úlcera varicosa en el miembro inferior izquierdo de 15 meses de evolución, tratada únicamente con el medicamento homeopático Pulsatilla nigricans en diferentes diluciones. La paciente mostró una rápida respuesta favorable, que llevó a la curación casi completade la úlcera en menos de 5 meses de tratamiento.

O artigo descreve o caso de uma paciente d 86 anos de idade com extensa úlcera varicosa na perna com 15 meses de evolução, tratada exclusivamente com o medicamento homeopático Pulsatilla nigrincas, em várias diluições. A paciente melhorou rapidamente e úlcera curou quase completamente em menos de 5 meses.

This article reports the case of an 86 year-old woman presenting an extended varicose ulcer in her lower left limb for 15 months, treated exclusively with homeopathic medicine Pulsatilla nigricans in various dilutions. The patient improved quickly, and the ulcer cured almost completely in less than 5 months.

Prospective observational study of 42 patients with atopic dermatitis treated with homeopathic medicines.

BACKGROUND: Atopic dermatitis (AD) is a highly prevalent chronic inflammatory skin disease which usually develops during childhood. Despite being a condition frequently treated with homeopathy, the evidence is still insufficient to define homeopathic treatment's efficacy and the best therapeutic strategies. AIMS: To evaluate the effectiveness of homeopathic treatment of AD in a general homeopathic practice setting. METHODS: Patients spontaneously seeking homeopathic treatment meeting Hanifin and Rajka's criteria were prospectively treated. Severity of disease was evaluated by Rajka and Langeland's score and a set of four Visual Analogue Scales (VAS) evaluating disease severity, itch, general and psychological wellbeing and quality of sleep. Assessed outcomes were: change in AD extension, change in VASs, and a categorical scale for global subjective perception of evolution. RESULTS: Forty two patients were eligible. Twenty-one had other atopic comorbidities and 28 (66.7%) were moderate or severe cases. Sixteen (38.1%) patients dropped out. Significant differences were found comparing first and last consultations in mean percentage (95%CI) of affected skin area, 21.1% (10.9; 31.4) versus 5.5% (1.3; 9.7) respectively, P=0.002, and in the change or the four VASs: [mm (95%CI)] AD 31.1 (20.6; 41.7), P<0.0001; Itch 35.0 (23.6; 46.4), P<0.0001; General wellbeing 11.1 (1.2; 20.9), P<0.0188, and Sleep 17.4 (5.0; 29.8), P<0.0073. Homeopathic aggravations were reported after 29.8% of prescriptions. Twelve individualized homeopathic medicines were prescribed; Sulphur accounted for 60% of cases with good treatment response. CONCLUSIONS: This study suggests that in a general medical practice setting, homeopathic treatment could be regarded as an effective choice for patients with AD.

First Edition of Hahnemann's Organon: Celebrating its 200th Anniversary

With this special issue, IJHDR celebrates the 200th anniversary of the first edition of Hahnemann?s Organon, published in 1810. By 1796, in a previous foundational article published in Hufeland?s prestigious Journal of Practical Medicine [1], after criticizing with fine reasoning the usual ways of studying the ?curative properties of medicinal substances?, namely according to their chemical actions, their effects on animals, their external aspect or sensitive properties, their taxonomic classification, or the random use of multiple drugs by the so called empiricists, Hahnemann stated what can be regarded as one of the cornerstones of homeopathy: ?The true physician, whose sole aim is to perfect his art, can avail himself of no other information respecting medicines, than ? first, what is the pure action of each by itself on the human body? Second, what do observations of its action in this or that simple or complex disease teach us?(AU)

First Edition of Hahnemann's Organon: celebrating its 200th anniversary: [editorial]

With this special issue, IJHDR celebrates the 200th anniversary of the first edition of Hahnemann?s Organon, published in 1810. By 1796, in a previous foundational article published in Hufeland?s prestigious Journal of Practical Medicine [1], after criticizing with fine reasoning the usual ways of studying the ?curative properties of medicinal substances?, namely according to their chemical actions, their effects on animals, their external aspect or sensitive properties, their taxonomic classification, or the random use of multiple drugs by the so called empiricists, Hahnemann stated what can be regarded as one of the cornerstones of homeopathy: ?The true physician, whose sole aim is to perfect his art, can avail himself of no other information respecting medicines, than ? first, what is the pure action of each by itself on the human body? Second, what do observations of its action in this or that simple or complex disease teach us?.

REDIMEH Project: Ibero-american integrative network for clinical research in Homeopathy / Projeto REDIMED: Rede Integrada ibero-americana para pesquisa clínica em Homeopatia

If conscious medically oriented homeopaths were asked to name one single missing orin sufficiently developed subject, the answer would probably be high quality clinical research. In this regard, a large part of the homeopathic community continues to insist on traditional models of building knowledge, although they had led us nowhere. On the other hand, there is a current agreement among clinical researchers that enough effort has been devoted to clinical trials. Inspite of this, there is still lacking high quality scientific research useful to improve the daily practice of clinical practitioners. This article introduces REDIMEH, an Ibero-American integrative network for clinical research in homeopathy aiming exclusively at joining efforts to collect clinical data sufficient to draw out valid conclusions.

Se pudermos apontar uma questão, a qual os verdadeiros médicos homeopatas podem se lamentar, esta deveria ser a falta ou insuficiência de pesquisas clínicas de alta qualidade. Uma grande parte da comunidade homeopática ainda insiste nas formas tradicionais de construção de conhecimento, levando-nos a lugar algum. Existem pontos bem estabelecidos pelos pesquisadores clínicos que tem se esforçado muito com a realização de Ensaios Controlados Randomizados (RCT). O que mais precisamos hoje é de investigação científica de boa qualidade, que possa melhorar a nossa prática diária. Este artigo apresenta o projeto REDIMEH, uma Rede Integrada Ibero-Americana para Pesquisa Clínica em Homeopatia, de estrutura horizontal, sem objetivos políticos, com a intenção de unir esforços no sentido de obter dados clínicos suficientes para chegarmos a conclusões válidas para a prática clínica diária.

REDIMEH Project: Ibero-American Integrative Network for ClinicalResearch in Homeopathy / Projeto REDIMED: Red Integrada Ibero-Americana para Pesquisa Clínica em Homeopatia

If conscious medically oriented homeopaths were asked to name one single missing orinsufficiently developed subject, the answer would probably be high quality clinical research. Inthis regard, a large part of the homeopathic community continues to insist on traditional modelsof building knowledge, although they had led us nowhere. On the other hand, there is a currentagreement among clinical researchers that enough effort has been devoted to clinical trials. Inspite of this, there is still lacking high quality scientific research useful to improve the dailypractice of clinical practitioners. This article introduces REDIMEH, an Ibero-Americanintegrative network for clinical research in homeopathy aiming exclusively at joining efforts tocollect clinical data sufficient to draw out valid conclusions.(AU)

Se pudermos apontar uma questão, a qual os verdadeiros médicos homeopatas podem se lamentar, esta deveria ser a falta ou insuficiência de pesquisas clínicas de alta qualidade. Uma grande parte da comunidade homeopática ainda insiste nas formas tradicionais de construção de conhecimento, levando-nos a lugar algum. Existem pontos bem estabelecidos pelos pesquisadores clínicos que tem se esforçado muito com a realização de Ensaios Controlados Randomizados (RCT). O que mais precisamos hoje é de investigação científica de boa qualidade, que possa melhorar a nossa prática diária. Este artigo apresenta o projeto REDIMEH, uma Rede Integrada Ibero-Americana para Pesquisa Clínica em Homeopatia, de estrutura horizontal, sem objetivos políticos, com a intenção de unir esforços no sentido de obter dados clínicos suficientes para chegarmos a conclusões válidas para a prática clínica diária.(AU)

Protocolo homeopático de observação clínica em dermatite atópica: proposta para estudo multicêntrico / Protocol of homeopathic clinical observation in atopic dermatitis: suggestion for a multicenter study

A dermatite atópica é uma moléstia inflamatória crônica da pele associada com prurido. Em 90% dos casos começa na infância e no mínimo, na metade dos pacientes, se associa com rinite alérgica ou asma bronquial. Sua prevalência vem aumentando continuamente, e o tratamento convencional nem sempre é efetivo e inócuo. Experiência prévia com tratamentos homeopáticos aponta para efetividade desta modalidade de intervenção, mas ainda não há suficientes estudos em larga escala para comprová-la. Este artigo apresenta o PH-DA, um protocolo de observação clínica no tratamento homeopático da dermatite atópica destinado a ser utilizado em estudos multicêntricos.

Atopic dermatitis is a chronic inflammatory skin disease attended with itch. 90% of cases begin in childhood and adolescence and at least in half of patients is associated with allergic rhinitis or bronchial asthma. Its prevalence has been steadily increasing in the developed countries, while conventional treatment is not systematically effective and innocuous. Previous experiences with homeopathic treatment point out to the effectiveness of this homeopathic approach, but large-scale studies are still lacking. This paper presents PH-DA, a protocol of clinical observation for the homeopathic treatment of atopic dermatitis aiming at being applied in multicentric studies.

Protocolo homeopático de observação clínica em dermatite atópica: proposta para estudo multicêntrico / Protocol of homeopathic clinical observation in atopic dermatitis: suggestion for a multicenter study

A dermatite atópica é uma moléstia inflamatória crônica da pele associada com prurido. Em 90% dos casos começa na infância e no mínimo, na metade dos pacientes, se associa com rinite alérgica ou asma bronquial. Sua prevalência vem aumentando continuamente, e o tratamento convencional nem sempre é efetivo e inócuo. Experiência prévia com tratamentos homeopáticos aponta para efetividade desta modalidade de intervenção, mas ainda não há suficientes estudos em larga escala para comprová-la. Este artigo apresenta o PH-DA, um protocolo de observação clínica no tratamento homeopático da dermatite atópica destinado a ser utilizado em estudos multicêntricos.(AU)

Atopic dermatitis is a chronic inflammatory skin disease attended with itch. 90% of cases begin in childhood and adolescence and at least in half of patients is associated with allergic rhinitis or bronchial asthma. Its prevalence has been steadily increasing in the developed countries, while conventional treatment is not systematically effective and innocuous. Previous experiences with homeopathic treatment point out to the effectiveness of this homeopathic approach, but large-scale studies are still lacking. This paper presents PH-DA, a protocol of clinical observation for the homeopathic treatment of atopic dermatitis aiming at being applied in multicentric studies.(AU)