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DOI: 10.1055/a-2562-8734
Prognostic Factor Research in Homeopathy: Overview of the Method, with Insights from Condition-Confined Studies

Abstract
Background
A prognostic factor (PF) refers to any feature of a disease or a characteristic of a patient that can be used to predict the likely outcome or course of a disease in an individual. Prognostic factor research (PFR), which is relatively new in homeopathy, focuses on investigating PFs and helps in therapeutic decision-making. The main challenge is the large number of eligible symptoms, but these can be reduced by condition-confined assessment, in which PFR is restricted to sub-populations of patients suffering from the same disease or condition. Condition-confined PFR (CC-PFR) identifies useful medicines for a given disease and compares with great precision different medicines regarding their relationship with common symptoms.
Objective
To overview PFR and the findings from CC-PFR studies in homeopathy to date.
Methods
A review of PFR, followed by a summary of six CC-PFR studies in homeopathy for coronavirus disease 2019 (COVID-19) was performed, outlining the methods, the challenges, the interpretation of outcomes and the lessons learned from each of the six studies in considering the further development of this model.
Findings
The six CC-PFR studies during COVID-19 identified PFs for the 10 most frequently used medicines: Bry, Ars, Puls, Gels, Bell, Hep, Nux-v, Phos, Puls and Rhus-t. These PFs usually contain common symptoms, which in combination become ‘specific’ enough to select a medicine. These PFs or symptoms also helped to differentiate between these 10 medicines. This model was reproducible and the outcomes were verifiable in the subsequent waves of COVID-19. The outcomes of CC-PFR studies were mostly generalisable and resulted in the preparation of a mini-repertory and repertorisation app. However, these studies revealed key issues. The main problems were the reliability of observations, identification of biases and assessing causality. The quality of PFR data depends on the scientific skills of practitioners, who are typically not trained researchers. Thus, they require additional training in data collection, methods, management of bias and causal analysis.
Conclusion
CC-PFR improves the reliable use of common symptoms and thus reduces the inappropriate use of peculiar symptoms based on confirmation bias. CC-PFR studies may be helpful in diseases where rare and peculiar symptoms are difficult to find, for example in one-sided ailments, and in epidemic diseases. PFR, however, requires reliable observations by the participating practitioners. Hence, training and encouragement of clinicians is needed to develop the existing data and integrate research into everyday clinical practice.
Publication History
Received: 07 January 2025
Accepted: 19 March 2025
Article published online:
28 July 2025
© 2025. Faculty of Homeopathy. This article is published by Thieme.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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References
- 1 von Schoen-Angerer T, Manchanda RK, Lloyd I. et al. Traditional, complementary and integrative healthcare: global stakeholder perspective on WHO's current and future strategy. BMJ Glob Health 2023; 8: e013150
- 2 Rutten L. Confirmation and confirmation bias: the role of prognostic factor research. Indian J Res Homoeopathy 2017; 11: 262-268
- 3 Hahnemann S. Organon of Medicine. 6th ed.. New Delhi: B. Jain Publishers; 2004: 150
- 4 Shang A, Huwiler-Müntener K, Nartey L. et al. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. Lancet 2005; 366: 726-732
- 5 National Health and Medical Research Council.. NHMRC Information Paper: Evidence on the effectiveness of homeopathy for treating health conditions. Canberra, Australia: National Health and Medical Research Council; 2015
- 6 Gaertner K, von Ammon K, Fibert P. et al. Recommendations in the design and conduction of randomised controlled trials in human and veterinary homeopathic medicine. Complement Ther Med 2023; 76: 102961
- 7 Gill CJ, Sabin L, Schmid CH. Why clinicians are natural Bayesians. BMJ 2005; 330: 1080-1083
- 8 Goodman SN. Toward evidence-based medical statistics. 2: The Bayes factor. Ann Intern Med 1999; 130: 1005-1013
- 9 Bayes T. An essay towards solving a problem in the Doctrine of Chances. Philos Trans R Soc Lond 1763; 53: 370-418
- 10 Rutten ALB, Stolper CF, Lugten RFG, Barthels RW. Assessing likelihood ratio of clinical symptoms: handling vagueness. Homeopathy 2003; 92: 182-186
- 11 Rutten ALB, Stolper CF, Lugten RFG, Barthels RW. ‘Cure’ as the gold standard for likelihood ratio assessment: theoretical considerations. Homeopathy 2004; 93: 78-83
- 12 Simms L, Barraclough H, Govindan R. Biostatistics primer: what a clinician ought to know–prognostic and predictive factors. J Thorac Oncol 2013; 8: 808-813
- 13 Hermanek P. Prognostic factor research in oncology. J Clin Epidemiol 1999; 52: 371-374
- 14 Riley RD, Moons KGM, Hayden JA, Sauerbrei W, Altman DG. Prognostic factor research. In: Riley RD, van der Windt D, Croft P, Moons K. (eds). Prognosis Research in Healthcare: Concepts, Methods, and Impact. Oxford Academic; 2019.
- 15 Hamoodi Z, Gehringer CK, Bull LM. et al. Prognostic factors associated with failure of total elbow replacement: a protocol for a systematic review. BMJ Open 2023; 13: e071705
- 16 Riley RD, Hayden JA, Steyerberg EW. et al. Prognosis Research Strategy (PROGRESS) 2: Prognostic factor research. PLoS Med 2013; 10: e1001380
- 17 Zhou M, Huang H, Fan Y, Chen M, Li M, Wang Y. The application of quantitative perfusion analysis of golden-angle radial sparse parallel MRI and R2∗ value for predicting pathological prognostic factors in rectal cancer. Clin Radiol 2024; 79: 124-132
- 18 Chen M, Huang L, Wang F, Xu X, Xu X. Competing risk model to determine the prognostic factors for patients with gliosarcoma. World Neurosurg 2024; 183: e483-e494
- 19 Dubbelman Y, Wildhagen M, Schröder F, Bangma C, Dohle G. Orgasmic dysfunction after open radical prostatectomy: clinical correlates and prognostic factors. J Sex Med 2010; 7: 1216-1223
- 20 Pitre T, Lupas D, Ebeido I. et al. Prognostic factors associated with mortality in acute exacerbations of idiopathic pulmonary fibrosis: a systematic review and meta-analysis. Respir Med 2024; 222: 107515
- 21 Tunthanathip T, Phuenpathom N, Jongjit A. Prognostic factors and clinical nomogram for in-hospital mortality in traumatic brain injury. Am J Emerg Med 2024; 77: 194-202
- 22 Miglani A, Rutten L, Manchanda RK. Generalisability of prognostic factor research: further analysis of data from the IIPCOS2 study. Homeopathy 2017; 106: 155-159
- 23 The Aurum Project. Update: number of homeopathic remedies available now is 8,661. Accessed December 14, 2024 at: https://aurumproject.org.au/homeopathic-remedies-8200
- 24 Miglani A, Manchanda RK. Observational study of Arctium lappa in the treatment of acne vulgaris. Homeopathy 2014; 103: 203-207
- 25 Miglani A, Manchanda RK. Prospective, non-randomised, open-label study of Zingiber officinale in the treatment of acne vulgaris. Focus Altern Complement Ther 2014; 19: 191-197
- 26 Miglani A, Manchanda RK. Azadirachta indica in treatment of acne vulgaris – an open-label observational study. Indian J Res Homoeopathy 2014; 8: 218-223
- 27 Doshi A, Zaheer A, Stiller MJ. A comparison of current acne grading systems and proposal of a novel system. Int J Dermatol 1997; 36: 416-418
- 28 Girman CJ, Hartmaier S, Thiboutot D. et al. Evaluating health-related quality of life in patients with facial acne: development of a self-administered questionnaire for clinical trials. Qual Life Res 1996; 5: 481-490
- 29 Martin AR, Lookingbill DP, Botek A, Light J, Thiboutot D, Girman CJ. Health-related quality of life among patients with facial acne – assessment of a new acne-specific questionnaire. Clin Exp Dermatol 2001; 26: 380-385
- 30 Fehnel SE, McLeod LD, Brandman J. et al. Responsiveness of the Acne-Specific Quality of Life Questionnaire (Acne-QoL) to treatment for acne vulgaris in placebo-controlled clinical trials. Qual Life Res 2002; 11: 809-816
- 31 Shinde V. Homoeopathy in pandemic Spanish flu 1918. Indian J Res Homoeopathy 2020; 14: 152-159
- 32 Manchanda RK, Miglani A, Gupta M. et al. Homeopathic remedies in COVID-19: prognostic factor research. Homeopathy 2021; 110: 160-167
- 33 Miglani A. Effect of lockdown during COVID-19: an Indian perspective. Int J Sci Healthcare Res 2020; 5: 55-61
- 34 Ho CS, Chee CY, Ho RC. Mental health strategies to combat the psychological impact of COVID-19 beyond paranoia and panic. Ann Acad Med Singap 2020; 49: 155-160
- 35 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
- 36 van Haselen RA. Homeopathic clinical case reports: development of a supplement (HOM-CASE) to the CARE clinical case reporting guideline. Complement Ther Med 2016; 25: 78-85
- 37 Manchanda RK, Miglani A, Chakraborty M. et al. Impact of bias in data collection of COVID-19 cases. Homeopathy 2022; 111: 57-65
- 38 Manchanda RK, Miglani A, Chakraborty M. et al. Homeopathic medicines in second wave of COVID-19: prognostic factor research. Homeopathy 2023; 112: 12-21
- 39 Manchanda RK, Miglani A, Kalsi A. et al. Homeopathic medicines in third (Omicron) wave of COVID-19: prognostic factor research. Homeopathy 2024; 113: 223-230
- 40 Rutten L, Miglani A, Gold P. et al. Generalizability of homeopathic prognostic factor research outcome in COVID-19 treatment: comparison of data. Homeopathy 2022; 111: 157-163
- 41 Miglani A, Manchanda RK, Kalsi A. et al. Test of a homeopathic algorithm for COVID-19: the importance of a broad perspective. Homeopathy 2023; 112: 22-29
- 42 Rutten L, Eizayaga J, Gold P. et al. Homeopathy for acute viral infections: a Bayesian repertory for reliable use of common symptoms. Homoeopath Links 2024; 37: 11-16
- 43 Lamba CD, Gupta VK, van Haselen R. et al. Evaluation of the Modified Naranjo Criteria for assessing causal attribution of clinical outcome to homeopathic intervention as presented in case reports. Homeopathy 2020; 109: 191-197
- 44 Nickerson RS. Confirmation bias: a ubiquitous phenomenon in many guises. Rev Gen Psychol 1998; 2: 175-220
- 45 Fisher P. Send in your cases, or the lost art of the concise case report. Homeopathy 2002; 91: 195-196
- 46 Kaur H, Rutten L, Lamba CD. et al. Homoeopathic treatment for chronic cough – a multicentric, prospective, observational cohort study. Int J High Dilution Res 2024; 23: 146-160