Prognostic Factor Research on Homeopathic Cough Treatment in India

There are good reasons to optimise homeopathic prescribing for cough, the most frequent indication in general practice. There is some evidence of efficacy of homeopathy for cough. However, opinions about best homeopathic medicines for cough diverge. Repertories and materia medica are unclear about the best medicines and the indicating symptoms for these medicines. According to Bayes’ theorem, a symptom is an indication for a medicine, only if the prevalence of the symptom in the population responding well to that medicine is higher than in the remainder of the population (likelihood ratio [LR]). Higher LR means a better symptom. This requires quantitative analysis of clinical data.

Multi-centre, prospective, observational study during 2 years in 10 centres of the Central Council for Research in Homoeopathy (CCRH) was conducted. This program assesses both acute cough (<6 days) and chronic cough (>8 weeks). Treatment and research are separated: The research is done by doctors trained in research methodology. These doctors interview the patients with questionnaires assessing homeopathic symptoms and results. The sample size is expected to exceed 5,000. Three questionnaires are applied:

1. Leicester Cough Questionnaire (LCQ) for chronic cough and LCQ acute for acute cough, a validated instrument to assess cough treatment

2. Questionnaire for homeopathic cough-related symptoms

3. Questionnaire for general homeopathic symptoms.

The homeopathic questionnaires are being tested in pilot studies, such as the cut-off value for the intensity of symptoms. Likert scales are used to provide more flexibility, and doctors are trained to manage the questionnaires.

The relationship between improvement by specific homeopathic medicines and symptoms is assessed. Furthermore, the relationship between cough-related diagnoses and homeopathic medicines is assessed. In total, 228 repertory-rubrics will be validated. The causal relationship between result and medicine will be assessed by clinical judgement of the treating doctor and by the modified Naranjo algorithm.

Keywords: Cough, Bayes' theorem, prognostic factor research, modified Naranjo algorithm