Monitoring improvement in health during homeopathic intervention. Development of an assessment tool based on Hering’s Law of Cure: the Hering’s Law Assessment Tool (HELAT)

Sarah B. Brien; Hugh Harrison; June Daniels; George Lewith

doi:10.1016/j.homp.2011.10.002

Homeopathy, Table of Contents

Homeopathy 2012; 101(01): 28-37
DOI: 10.1016/j.homp.2011.10.002

Original Paper

Monitoring improvement in health during homeopathic intervention. Development of an assessment tool based on Hering’s Law of Cure: the Hering’s Law Assessment Tool (HELAT)

Sarah B. Brien

¹University of Southampton, UK

,

Hugh Harrison

²Watchbell House Natural Therapy Centre, 8 Lugley Street, Newport, Isle of Wight PO30 5HD, UK

,

June Daniels

³The Highfield Natural Health Centre, 17 Highfield Lane, Highfield, Southampton S017 1QD, UK

,

George Lewith

⁴Department of Primary Care, Faculty of Medicine, University of Southampton, Southampton, UK

› Author Affiliations
Subject Editor:

Abstract

Introduction: Hering’s ‘Law of Cure’ is considered important in homeopathy and thought to predict a positive outcome to treatment. No formal outcome measures are currently available to monitor response to homeopathic treatment on the basis of these assumptions. We describe a simple assessment tool, the Hering’s Law Assessment Tool (HELAT) to identify and differentiate patient responses to homeopathic treatment as corresponding to Hering’s Law from other symptomatic responses. We describe the development of the tool and assess its face, content and predictive validity.

Method: The HELAT was initially developed through literature review, discussion between homeopaths and clinical experience. In phase one, the tool was reviewed by three experienced homeopaths to assess face and content validity. In phase two, we tested its predictive validity by hypothesizing that the HELAT total score may predict changes in a clinical response (using standard validated rheumatological outcome, the American College of Rheumatology (ACR)20%) in 32 patients with rheumatoid arthritis receiving homeopathic intervention over 24 weeks as part of a clinical trial.

Results: The HELAT was piloted and changed to improve face and content validity and the final version was then employed for phase two as a predictor of outcome. HELAT total score predicted patient’s clinical response (ACR20) [B = 1.142, SE = 0.462, P = 0.013] which was independent of practitioner assessing the patients treatment response [B = 1.04, SE = 1.01, P = 0.302].

Conclusion: The initial data suggests that the HELAT may hold promise for a potential clinical and research outcome measure in homeopathy. Further work is now needed to formally assess its reliability and validity for potential use in clinical practice and trials.

Keywords

Hering’s law - Questionnaire - Homeopathy - Outcome

Full Text

References

References
1 Hahnemann S.C. Organon of medicine. 6th edn. New Delhi: B. Jain Publishers; 1970. Paragraph 6.
2 Kent J.T. Correspondence of organs, and direction of cure. Trans Soc Homœopathicians 1911; 1: 31-33.
3 Hering C. Hahnemann’s three rules concerning the rank of symptoms. Hahnemannian Monthly 1865; 1: 5-12.
4 Vithoulkas G. Paragraphs 46 and 47. In: Vithoulkas G (ed) A New Model for Health and Disease. California: Health and Habitat, 1997, pp 150–151.
5 Vithoulkas G. Chapter 15. The follow up interview; and Chapter 16: principles involved in long term management. In: Vithoulkas G. The Science of Healing. 2000. New Delhi: B.Jain Publishers Ltd; 231-240.
6 Coulter H. Chapter 3: symptoms as positive phenomena. In: Coulter H. Homoeopathic Science and Modern Medicine. 1980. Richmond: North Atlantic Books; 26-33.
7 Hahnemann S.C. The medicine of experience. The Lesser Writings of Samuel Hahnemann. 1995. New Delhi: B. Jain Publishers.;
8 Kent J.T. Lecture 35: prognosis after observing the action of the remedy. In: Kent J.T. Lectures on Homeopathic Philosophy . 1991. New Delhi: B. Jain Publishers.;
9 Anelli M., Scheepers L., Sermeus G., van Wassenhoven M. Homeopathy and health related Quality of Life: a survey in six European countries. Homeopathy 2002; 91 (01) 18-21.
10 Oberbaum M., Singer S.R., Vithoulkas G. The colour of the homeopathic improvement: the multidimensional nature of the response to homeopathic therapy. Homeopathy 2005; 94 (03) 196-199.
11 Roberts H.A. Chapter XIV. In: Roberts H.A. Principles and Art of Cure by Homeopathy. 1936. New Delhi: B. Jain Publishers; 124-134.
12 Streiner D.L., Norman G.R. Health measurement scales: a practical guide to their development and use. Oxford: Oxford University Press; 1989.
13 Vithoulkas G. Appendix B: patient evaluations at one month. Case XIII. In: Vithoulkas G. The Science of Healing. 2000. New Delhi: B.Jain Publishers Ltd; 310.
14 Arnett F.C., Edworthy S.M., Bloch D.A. et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988; 31 (03) 315-324.
15 Brien S.B., Lachance L., Prescott P., McDermott C., Lewith G. Evaluating the effects of homeopathy in rheumatoid arthritis; are they attributable to the consultation process or the homeopathic remedy? A randomised, controlled trial. Rheumatology 2010 10.1093/rheumatology/keq234.
16 Felson D.T., Anderson J.J., Boers M. et al. American College of Rheumatology preliminary definition of improvement in rheumatoid arthritis. Arthritis Rheum 1995; 38: 727-735.
17 Worsley J.R., Worsley J.B. Warwickshire: The College of Traditional Acupuncture, U.K; Traditional acupuncture: traditional diagnosis. Vol. II. 1990.
18 Hicks A., Hicks J., Mole P. Appendix E: treatment reactions. In: Hicks A., Hicks J., Mole P. Five Element Acupuncture . 2004. Philadelphia: Churchill Livingstone; 386.
19 Thompson E., Barron S., Spence D. A preliminary audit investigating remedy reactions including adverse events in routine homeopathic practice. Homeopathy 2004; 93 (04) 203-209.
20 Dantas F., Rampes H. Do homeopathic medicines provoke adverse effects? A systematic review. Br Homeopath J 2000; 89 (Suppl. 01) S35-S38.
21 Venulet J. Informativity of adverse drug reactions data in medical publications. Drug Info J 1985; 19: 357-365.
22 Dean M.E., Coulter M.K., Fisher P., Jobst K., Walach H. Delphi Panel of the CONSORT Group. Reporting data on homeopathic treatments (RedHot): a supplement to CONSORT. Forsch Komplementmed 2006 Dec; 13 (06) 368-371 Epub 2006 Dec 21.
23 Grabia S., Ernst E. Homeopathic aggravations a systematic review of randomised, placebo-controlled clinical trials. Homeopathy 2003; 92: 92-98.