British Homoeopathic Journal January 1998, Vol. 87, pp. 51-55

International press abstracts and reviews

Alternative designs for research projects K.J. THOMAS, M.J. FITTER The authors discuss two randomised clinical trial techniques: partial randomisation or randomised block design and what is called a 'pragmatic' design with prior randomisation. In the first case recruited patients are asked if they have a clear preference for one of the two treatments being offered, one being 'new' and the other 'normal'. If they do, they are assigned to groups A and D. If they do not, they are randomly assigned to either the new group (B) or the 'normal' group (C). It is claimed that this procedure maximises the proportion of the population included as well as accommodating patient preferences.

In the second design the target group of patients is identified by an agreed set of criteria. Once identified, patients are randomly assigned to two groups representing new and normal treatments. Patients in the new group may choose the new treatment, or normal treatment, in which case they are transferred to a third group. This design provides useful information on the likely uptake of the new therapy and on the effectiveness of the new treatment in comparison with normal management. There are various strengths and weaknesses of the two types of randomisation and these are summarised in the paper. Complementary Therapies in Medicine 1997;

5: 94-98.

Treatment of URTI G.T. LEWITH This paper examines the literature evidence for the use of homoeopa thy and dietary exclusion in the management of URTI and otitis media and concludes that there is good evidence for the positive effects of homoeo- pathic treatment. There is little such evidence for the value of food exclusion, although there is some circumstantial evidence that avoiding milk can be of benefit in the management of chronic tonsillitis and secretory otitis media. Complementary Therapies in Medicine 1997;

5: 99-101.

Grant applications F.J. FREY, C.R.B. JOYCE An attempt by an expert committee appointed by the Swiss National Research Foundation to implement a decision protocol that satisfied requirements. The method of choosing 17 of 219 applications for support involved using judgement analysis. Appropriate standards such as relevance to the programme objectives and methodological adequacy were assessed, with relative weights attached to these stan- dards by committee members using multiple linear regression. A single common policy, based on s tandards that had been made explicit, was then applied to the choice of projec ts supported. The method proved acceptable to the members of an expert com- mittee drawn from a wide range of disciplines.

Alternative Therapies 1997; 3: 35-38.

Nasal sprays S. ZENNER, H. METELMANN A homoeopathic rhinologic agent in spray form was tested for efficacy in this study. A total of 381 physicians supplied documentation on 3,510 cases involving mainly acute rhinitis although eight other associated conditions were also treated. 38.5% of patients received the spray alone; the remainder required additional measures, either pharmaceutical, non-pharmaceutical or both. The average dose was 4.84 sprays per nostril per day for adults and 3.57 sprays per nostril per day for children under 6. In more than half the cases duration of treatment was from 1-4 weeks. Results indicated that 81% of the total patient population recorded 'good ' or 'very good' outcomes. The documentation is impressive but no attempt is made to quantify exactly what constituted a 'good' or 'very good' outcome. Considerable differences in the duration of symptoms were noticed. The application of a technique such as the Glasgow Homoeopathic Hospital Outcome Scale would have improved the quality of the results considerably.

Biological Therapy 1997; 15: 82-8.

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