Improving homeopathic prescribing

Abstract

Every medical practitioner has to consider his, or her, treatment choices and the rationale behind every therapeutic decision. In homeopathic practice, the question of remedy choice is particularly acute. In his paper on Polarity Analysis in this issue of Homeopathy, Heiner Frei demonstrates that improved outcomes are possible through refinements in the analysis methodology for homeopathic remedy selection. 1 Homeopathic clinicians invest a lot of time in the process of collecting clinical data from their patients. This is primarily because the clinical process is quasi-individualised and also because the contexts in which the illness and its symptoms have emerged may have a direct bearing on the choice of treatment. Successful outcomes are achieved when we successfully mirror complexity with complexity and identified treatment inputs that are context-sensitive.To achieve these results with consistency, however, we need to be able to access a portfolio of meaningful data and, within this, we need to be able to identify reliable subsets that have direct applicability to each new clinical presentation. This process of profile-matching also requires tools which help us to construct an argument for each specific treatment. Ideally these resources should engender a method of analysis which is rational and which advances the reliability of the data itself, over time. Improving confidenceTwo other papers in this issue propose statistical methods for the advancement of confidence in our homeopathic data and its application.Rutten et al. present a statistical method for establishing likelihood ratios for individual remedy entries in symptom rubrics. In their collaborative, prospective study, they demonstrate that by establishing likelihood ratios for each remedy, we can provide a rational basis for assessing the strength of the symptom-remedy relationship. 2 Kharal applies intuitionistic fuzzy set theory to the repertory data and demonstrates that symptom weighting, and indices of association, can be combined into analysis methodologies that utilise likelihood ratios. 3 In homeopathic practice the repertory is the main repository for our clinical remedy data. In his paper 'In Search of the Reliable Repertory' Ben Gadd identifies many of the shortcomings inherent, both in the data and the data set relationships within our homeopathic repertories at the present time. 4 There is general consensus among researchers with an interest in the homeopathic knowledge base, that we require a systematised and more consistent approach to data, in order that the further development of the repertory can truly be regarded as a scientific process.Currently in clinical practice, rather than attempt to mechanically cross-match data fields of uncertain reliability, experienced homeopathic clinicians use diverse techniques to enhance the discriminatory power of their analysis. Some of these methods have been incorporated into expert systems. However, the need for such complex, and sometimes opaque, analysis tools, can lead to confusion and dis...