BackgroundA method for assessing the model validity of randomised controlled trials of homeopathy is needed. To date, only conventional standards for assessing intrinsic bias (internal validity) of trials have been invoked, with little recognition of the special characteristics of homeopathy. We aimed to identify relevant judgmental domains to use in assessing the model validity of homeopathic treatment (MVHT). We define MVHT as the extent to which a homeopathic intervention and the main measure of its outcome, as implemented in a randomised controlled trial (RCT), reflect 'state-of-the-art' homeopathic practice.MethodsUsing an iterative process, an international group of experts developed a set of six judgmental domains, with associated descriptive criteria. The domains address: (I) the rationale for the choice of the particular homeopathic intervention; (II) the homeopathic principles reflected in the intervention; (III) the extent of homeopathic practitioner input; (IV) the nature of the main outcome measure; (V) the capability of the main outcome measure to detect change; (VI) the length of follow-up to the endpoint of the study. Six papers reporting RCTs of homeopathy of varying design were randomly selected from the literature. A standard form was used to record each assessor's independent response per domain, using the optional verdicts 'Yes', 'Unclear', 'No'. Concordance among the eight verdicts per domain, across all six papers, was evaluated using the kappa (κ) statistic.ResultsThe six judgmental domains enabled MVHT to be assessed with 'fair' to 'almost perfect' concordance in each case. For the six RCTs examined, the method allowed MVHT to be classified overall as 'acceptable' in three, 'unclear' in two, and 'inadequate' in one.ConclusionFuture systematic reviews of RCTs in homeopathy should adopt the MVHT method as part of a complete appraisal of trial validity.

BackgroundThere is little information regarding lay-people's representations of influenza and influenza-like illness in their day-to-day lives. An insight into these views may aid our understanding of community attitudes regarding official recommendations for its prevention.MethodsThis was a qualitative research. Semi-structured face-to-face interviews were conducted with 40 French participants from the community, and from five different locations. Questions elicited the participants' representations of onset of flu and influenza-like illness, as well as their views on what can/should be done to deal with symptoms and their personal experience with flu and flu-like symptoms.ResultsThematic content analyses allowed us to identify five main themes: the presence of a clear continuum between influenza-like illness and flu; a description of flu as a very contagious disease; flu as being benign, except in "frail people", which the respondents never considered themselves to be; interruption of daily activities, which could be considered pathognomonic for influenza for most subjects; self-medication as the main current practice, and requests for healthcare mainly to confirm an auto-diagnosis.ConclusionsThere was a large homogeneity in the representation of flu. There was also a gap between people's representations (i.e., a continuum from having a "cold" to having "influenza") and scientific knowledge (i.e., a distinction between "true" influenza and influenza-like illnesses based on the existence of a confirmatory virological diagnosis). This gap raises issues for current campaigns for flu prevention, as these may not be congruent with the representation of flu being responsible for interrupting daily activities while also being seen as a non-severe disease, as well as the perception that flu is only a risk to "frail people" though no participants considered themselves to be "frail".

The results of this study demonstrate the interest of homeopathic medicines for the prevention and treatment of migraine attacks in children. A significant decrease in the frequency, severity, and duration of migraine attacks was observed and, consequently, reduced absenteeism from school.

Seeking a pharmacist's advice for the management of ILI and ENT disorders has several public health benefits. The clinical improvement and high patient satisfaction observed validate the role of the pharmacist as a health professional of first resort.

Objective: This study was done to determine characteristics and management of patients in France visiting allopathic general practitioners (AGPs) and homeopathic general practitioners (HGPs) for influenza-like illness (ILI). Materials and Methods: Design: This was a prospective observational study. Settings/location: It was conducted in metropolitan France during the 2009-2010 influenza season. Subjects: Sixty-five HGPs and 124 AGPs recruited a total of 461 patients with ILI. Interventions: Patients were treated for ILI by their GPs. GPs and patients completed questionnaires recording demographic characteristics and patient symptoms when patients were included in the study. Patients reported satisfaction with treatment on day 4. Prescriptions were recorded by the GPs. Outcome measures: Outcome measures were patient characteristics, demographics, and symptoms at baseline; medications prescribed by type of physician; and satisfaction with treatment by type of physician and medication. Results: Most AGPs (86%), and most patients visiting them (58%) were men; whereas most HGPs (57%; p < 0.0001), and most patients visiting them (56%; p = 0.006) were women. Patients visiting AGPs were seen sooner after the appearance of symptoms, and they self-treated more frequently with cough suppressants or expectorants ( p = 0.0018). Patients visiting HGPs were seen later after the appearance of symptoms and they selftreated with homeopathic medications more frequently ( p < 0.0001). At enrollment, headaches ( p = 0.025), cough ( p = 0.01), muscle/joint pain ( p = 0.049), chills/shivering ( p < 0.001), and nasal discharge/congestion ( p = 0.002) were more common in patients visiting AGPs. Of these patients, 37.1% visiting AGPs were prescribed at least one homeopathic medication, and 59.6% of patients visiting HGPs were prescribed at least one allopathic medication. Patient satisfaction with treatment did not differ between AGPs and HGPs but was highest for patients treated with homeopathic medications only. Conclusions: In France, homeopathy is widely accepted for the treatment of ILI and does not preclude the use of allopathic medications. However, patients treated with homeopathic medications only are more satisfied with their treatment than other patients.