Estimation of the Likelihood Ratio of Different Symptoms for Six Homeopathic Medicines: Prognostic Factor Research

Abstract

Background Arsenicum album, Causticum, Nux vomica, Pulsatilla nigricans, Rhus toxicodendron and Sulphur are frequently prescribed homeopathic medicines; however, their symptoms, as mentioned in different homeopathic literature works, have rarely been investigated systematically. Likelihood ratio (LR), based on Bayesian statistics, may reflect a better estimation of the strengths of symptoms than the existing entries in the homeopathic literature.

Methods A prospective, longitudinal, analytical patient outcome study was conducted in the outpatient departments of D. N. De Homeopathic Medical College and Hospital, Kolkata, on 1,954 patients over 21 months. The outcomes were recorded at each follow-up using the Outcome Related to Impact on Daily Living (ORIDL) +4 to −4 scale. The average period of treatment for each participant was 3 months. The LRs of four symptoms for each of the six selected medicines were calculated.

Results One hundred and two different remedies were prescribed. The prevalence, LR + , and LR − , with respective 95% confidence intervals, of different symptoms were reported. The study found that the following symptoms had particularly high LR+ scores: “intense sympathy for the suffering of others” (Causticum, LR+ = 12.0); “dyspepsia from business anxiety” (Nux vomica, LR+ = 27.4); “burning pain relieved by heat” (Arsenicum album, LR+ = 29.6); “envy” (Pulsatilla nigricans, LR+ = 13.2); “desire for milk” (Rhus toxicodendron, LR+ = 7.5); “very selfish, no regard for others” (Sulphur, LR+ = 20.6). The findings corroborated well with the presentation of the symptoms in different homeopathic materia medica and repertories. ORIDL scores of +2 or greater were identified most prominently for Pulsatilla nigricans (n = 138) and Sulphur (n = 119).

Conclusion There was adequate evidence to attribute all the assessed symptoms to the medicines investigated. Further studies with a larger population are warranted to tackle the possible confirmation bias.

Keywords

Bayesian statistics - homeopathy - likelihood ratio - prevalence - prognostic factor research

Authors' Contributions (CRediT Statement)

- A.M., N.S., K.C., M.S., T.S., and A.D.: methodology, validation, conducting the investigation, data curation, and writing—original draft, review, editing.

- S.H., A.B., S.S., S.B., S.S., B.B., A.S., M.G., P.D., and S.K.M.: methodology, validation, conducting the investigation, resources, and writing—review and editing, supervision, project administration, funding acquisition.

- S.S., M.K., L.R.: conceptualization, methodology, formal analysis, data curation, writing—original draft, review, editing.

Data Availability

All data generated or analyzed during this study are included in this article. Further details, if required, are available from the corresponding author upon reasonable request.

Publikationsverlauf

Eingereicht: 10. Januar 2024

Angenommen: 16. April 2024

Artikel online veröffentlicht:
08. Juli 2024

• References

• 1 Manchanda RK. Improving validity and reliability of homeopathy. Indian J Res Homoeopathy 2019; 13: 69-71
• 2 Rutten L, Manchanda R. Homoeopathy: discussion on scientific validation. Indian J Res Homoeopathy 2016; 10: 66-74
• 3 Rutten L. Prognostic factor research in homoeopathy. Indian J Res Homoeopathy 2016; 10: 59-65
• 4 Rutten AL, Stolper CF, Lugten RF, Barthels RW. New repertory, new considerations. Homeopathy 2008; 97: 16-21
• 5 Rutten AL, Stolper CF, Lugten RF, Barthels RW. A Bayesian perspective on the reliability of homeopathic repertories. Homeopathy 2006; 95: 88-93
• 6 Rutten L. Homoeopathy deserves its own identity. Homoeopathic Links 2021; 34: 5-13
• 7 Koley M, Saha S, Das KD. et al. Prospective evaluation of a few homeopathic rubrics of Kent's repertory from a Bayesian perspective. J Evid Based Complementary Altern Med 2016; 21: 277-281
• 8 Manchanda RK, Parthasarathi C, Koley M. et al. Retrospective estimation of prevalence and likelihood ratio of general symptoms of 29 less frequently prescribed homeopathic medicines by clinical verification. Indian J Res Homoeopathy 2019; 13: 72-80
• 9 Rutten AL, Stolper CF, Lugten RF, Barthels RW. Statistical analysis of six repertory rubrics after prospective assessment applying Bayes' theorem. Homeopathy 2009; 98: 26-34
• 10 Eizayaga JE, Pozzi MI, Canan MC, Saravia L. Prevalence and likelihood ratio of symptoms in patients with good therapeutic response to Lycopodium clavatum. A retrospective study. Homeopathy 2016; 105: 78-83
• 11 Van Wassenhoven M. Towards an evidence-based repertory: clinical evaluation of Veratrum album. Homeopathy 2004; 93: 71-77
• 12 Eizayaga JE, Waisse S, Rutten L, Klein-Laansma C, Motura A. Prevalence and likelihood ratio of six objective signs among good responders to Natrum muriaticum: multi-center observational assessment. Homeopathy 2021; 110: 36-41
• 13 Bagchi S, Nayak C, Rutten L. et al. Assessment of likelihood ratio for four contact dermatitis symptoms of Vinca minor . Homeopathy 2018; 107: 209-217
• 14 Bikker AP, Mercer SW, Reilly D. A pilot prospective study on the consultation and relational empathy, patient enablement, and health changes over 12 months in patients going to the Glasgow Homoeopathic Hospital. J Altern Complement Med 2005; 11: 591-600
• 15 Sevar R. Audit of outcome in 455 consecutive patients treated with homeopathic medicines. Homeopathy 2005; 94: 215-221
• 16 Reilly D, Mercer SW, Bikker AP, Harrison T. Outcome Related to Impact on Daily Living: preliminary validation of the ORIDL instrument. BMC Health Serv Res 2007; 7: 139