Analysing homœopathic prescribing using the READ Classification and information technology

Searching for the Genus Epidemicus in Chinese Patients: Findings from the Clificol COVID-19 Clinical Case Registry

BACKGROUND

 The Clificol COVID-19 Support Project is an innovative international data collection project aimed at tackling some of the core questions in homeopathy. This paper reports on the further investigation of the genus epidemicus concept during the first wave of the pandemic in the Chinese population.

METHODS

 The design is an observational clinical case registry study of Chinese patients with confirmed or suspected coronavirus disease 2019 (COVID-19). The symptoms were prospectively collected via a 150-item questionnaire. The concept of genus epidemicus, including the role of treatment individualization, was investigated by analyzing whether presenting symptoms clustered into distinct groups. Two standard statistical analysis techniques were utilized: principal component analysis for extracting the most meaningful symptoms of the dataset; the k-means clustering algorithm for automatically assigning groups based on similarity between presenting symptoms.

RESULTS

 20 Chinese practitioners collected 359 cases in the first half of 2020 (766 consultations, 363 prescriptions). The cluster analysis found two to be the optimum number of clusters. These two symptomatic clusters had a high overlap with the two most commonly prescribed remedies in these sub-populations: in cluster 1 there were 297 prescriptions, 95.6% of which were Gelsemium sempervirens; in cluster 2 there were 61 prescriptions, 95.1% of which were Bryonia alba.

CONCLUSION

 This is the first study to investigate the notion of genus epidemicus by using modern statistical techniques. These analyses identified at least two distinct symptom pictures. The notion of a single COVID-19 genus epidemicus did not apply in the studied population.

Describing and improving homoeopathy

Large scale data collection combined with modern information technology is a powerful tool to evaluate the efficacy and safety of homoeopathy. It also has great potential to improve homoeopathic practice. Data collection has not been widely used in homoeopathy. This appears to be due to the clumsiness sof the methodology and the perception that it is of little value to daily practice. 3 protocols addressing different aspects of this issue are presented.

- A proposal to establish common basic data collection methodology for homoeopaths throughout Europe.

- A systematic survey of the results of homoeopathic treatment of patients with rheumatoid arthritis using quality of life and objective assessments.

- Verification of a set of homoeopathic prescribing features for Rhus toxicodendron.

These proposals are designed to be ‘user-friendly’ and to provide practical information relevant to daily homoeopathic practice.

Towards a new method for improving clinical homœopathy

Most prescribing indications in homœopathy are derived from clinical experience. There is a need to revise and update them. A new method known as systematic outcome correlation, which correlates outcome as measured by a standard clinical assessment, with prescription, is described. The method uses information technology and the Read clinical classification. Preliminary results in rheumatoid arthritis are presented. The method and results are critically examined with recommendations for future developments.

Systematic investigation of the decision process in homœopathy

Plans for two pilot studies concerning the homœopathic treatment of chronic and acute otitis media are presented. The intention of these studies is not only to look at the efficacy of the homœopathic treatment as a whole but also to investigate the efficacy of the individualized decision strategies. Based on the homœopathic literature a selection of decision strategies has been made. The reader is asked to criticize and supplement the chosen decision strategies.

The development of research methodology in homoeopathy

Homoeopathy is a form of complementary medicine based on treating 'like with like'. Its popularity with the public, and credibility with health professionals, has increased rapidly as a result of recent clinical trials demonstrating its efficacy. The results of a systematic review of clinical trials of homoeopathy are summarized. The main scientific obstacle to the acceptance of homoeopathy is its use of very high 'ultramolecular' dilutions. The action of these dilutions cannot be explained in terms of existing pharmacological concepts. This has lead to the 'information medicine' hypothesis, which postulates the storage of information in water and its transmission to sensitized biosystems. This hypothesis is starting to be supported by physics. 'Proving' drugs in order to determine their effects on healthy volunteers is a form of research practised by homoeopaths for 200 years, the methodology is continuing to evolve. Clinical trials in homoeopathy are complicated by the fact that treatment is highly individualised. Various approaches to the problem of individualization in controlled trials, including 'homoeopathy as indicated', 'single homoeopathic medicine' and 'individualized isopathy' are discussed. To improve homoeopathic practice its results should be critically audited, a method for doing this is described.