Biomedical subjects
Publications and source records attributed to R F G Lugten.
An interim assessment of likelihood ratio of homeopathic symptoms shows that there are serious flaws in Kent's repertory. The system of expressing relationship between symptoms and expected results from medicines by type-face is unclear and unreliable. Bayesian methods can improve this and expand the possibilities of the repertory including the possibility of interpreting the absence of expected symptoms.
If the likelihood ratio (LR) method is introduced, the repertory will gradually change as more symptoms are assessed. It will also change the use of the repertory: the most important medicines of each symptom rubric can be identified and relied on, even in large rubrics. This is also a good opportunity to correct structural shortcomings of the repertory, for instance, entries should be based on systematic analysis of materia medica instead of casual observations.
Treatment outcome in a pilot study indicates that it is possible to assess likelihood ratios of homeopathic symptoms. Entries in repertory rubrics can be validated, but must still be handled carefully. Prospective research is the only acceptable way. Software to support this research must be carefully designed to export correct data.
Clinical symptoms including homeopathic symptoms are often vague. There is reluctance to assess clinical symptoms as diagnostic instruments because they are hard to define. Still, clinical symptoms appear effective in daily practice. Expert systems and neural networks handle vague data successfully. Theoretical considerations predict the kind of problems we may expect. There is a difference between quantitative and qualitative vagueness. Vague data cause problems if we try to prove a hypothesis because of expectation bias. We assess likelihood ratio of homeopathic symptoms only to improve the method.
A pilot study was performed to investigate the possibilities and restrictions of likelihood ratio (LR) investigation using three symptoms. Qualitative vagueness and expectation bias is inherent in our method, but is, in part avoidable. It appears that experienced observers assess common homeopathic symptoms quite similarly. Clinical judgement is an essential part of our work and should be preserved during assessment of LR. The assessment does not influence clinical practice and can be maintained for a long period, provided the appropriate software is used. A limited range of symptoms seems most suitable for LR investigation.
A committee of the Dutch Association of Homeopathic Physicians is trying to validate materia medica by evaluating successful cases. These cases are presented and assessed by a group of experienced homeopathic physicians to provide indications about the prevalence of symptoms related to particular homeopathic medicines. The next logical question is whether epidemiological techniques can be applied to them. We have some ideas concerning the information these data can provide, based on epidemiological theory and limited experimental data. Theoretical investigation suggests that the epidemiological concept of likelihood ratio is well adapted to homeopathy. Researching and applying likelihood ratio will lead to more accurate materia medica and repertory. These considerations already indicate some shortcomings in the representation of rare remedies and the use of grading in the current repertories.