Research in Homoeopathy: Building a base using quality evidence

With over 200 million users worldwide, homoeopathy is the second most preferred system of treatment.^[1] The growing popularity of homoeopathy necessitates building scientific evidence. We have an increasing database of scientific evidence demonstrating the efficacy of homoeopathy. Clinical trials, systematic reviews and meta-analyses are being published in peer-reviewed indexed journals.^[2-4] The boundaries for the application of homoeopathy are now being expanded into hitherto unexplored areas such as veterinary sciences, agriculture, clinical psychiatry, geriatrics, acute emergencies^[5] and biomolecular research.^[6]

Despite its growing popularity, homoeopathy continues to face criticism for its role in healthcare, with demands for better quality evidence for its safety and efficacy. There are multiple reasons for this: The current research data may not be sufficiently robust, as there is a strong reluctance and at times aversion by practitioners to engage in evidence-based practice. Our postgraduate homoeopathic students are also unfortunately not involved in genuine research activities. Homoeopathic educational institutions need to incubate research and promote innovative practices, our undergraduate curriculum does not have any module to introduce research while the latest research in our science does not even figure in the curriculum. The need of the hour is to sensitise homoeopathic students and practitioners who are doing good clinical work toward publishing their cases in sufficient numbers to create an impact. These are vital links in creating an evidence base that will foster research values in our profession.

Randomised controlled trials (RCTs) are the gold standard for establishing the efficacy of any intervention, as they reduce bias and confounding factors that could influence the prognosis.^[7] However, RCTs in homoeopathy have their limitations, including inadequate sample sizes and poor recording/reporting. Another significant reason is that homoeopathy is essentially an individualised therapy, where treatment is based primarily on the individual’s characteristics of the disease, the physician is, therefore, a strong confounding element that is virtually impossible to eliminate. Hence, it takes considerable effort to ensure a minimal level of standardisation in the training of the clinician-researcher. Thus, sound observational studies and pragmatic trials need to be encouraged. The data generated from these studies must be showcased as they bring out the benefits accruing to the patients after homoeopathic treatment. All homoeopathic educational institutions must encourage their faculty and students to publish observational studies. This will ensure a good amount of evidence-based data.

Case reports need to be presented as per the HOM CASE (Homoeopathic Clinical Case Reports) guidelines and with appropriate scales of assessment along with homoeopathic remedy response evaluation of the follow-ups.^[8]

In this issue, we bring you well-documented and research-based papers. We have an original paper by Nazeema and Kumar demonstrating the scope of homoeopathy in treating cases of Hashimoto’s thyroiditis with low Vitamin D levels that assess the relationship between Vitamin D and antithyroid peroxidase antibody (TPOAb) levels.^[9]

We also have an interesting case series demonstrating the usefulness of homoeopathic medicine in the treatment of warts^[10] and evidence-based case reports demonstrating the efficacy of homoeopathy in irritant contact dermatitis^[11] and urolithiasis.^[12]

If we must make progress as a science, we have to make research our lead player. I am reminded of the words of the song ‘Guitar Man,’ performed by the legendary American soft rock band ‘Bread.’ The lines are:

‘Who draws the crowd and plays so loud

……it’s the guitar man

Who’s gonna steal the show

You know……it’s the guitar man’^[13]

Research must be the guitar man of homoeopathy; always in the front, always drawing the crowd and their cheers. Building a quality evidence base and promoting homoeopathic research among the profession is the need of the hour.

A recent devastating loss to homoeopathy and the Institute of Clinical Research was the death of Dr Kershasp N. Kasad. He was a master clinician, a prolific author and a great, sensitive and gentle human being. We pay homage to this legend of homoeopathy in the obituary note.