Relevance or plausibility? Health care and research recommendations
AbstractBackground: Several disease indications have been researched for homeopathic treatment. However, the degree of evidence of studies is not yet investigated for the whole of homeopathic care. Three levels of care are identified: 1. Basic/ community health level. 2. Professional/ primary care level, 3. Advanced/ specialist care level Methods: Browser searches were made to identify studies at the three levels; from major reviews the last 20 years. The degrees of evidence were further subdivided into the levels of care. Each care level was documented for 7 major areas of pathology: cardiovascular, respiratory, gastro intestinal, urogenital, Neuro-endocrino-immunological, infectious, degenerative-oncological diseases. Criteria for inclusion: for RCT’s a minimum of Jadad score 3. Results: A matrix yields an overview of studies of sufficient quality to make recommendations for health services to integrate homeopathic treatment into their package of service delivery. 75% of the included studies are performed at community health level only. Discussion: A disproportionate segment of RCT’s on community health level has been conducted, in relation to the actual teaching priorities on individual treatment in homeopathic practice, and professional profiling as ‘specialists’. External and model validity enhancing recommendations for RCTs are provided, and some disease-categories with sufficient evidence presented.