Monitoring improvement in health during homeopathic intervention. Development of an assessment tool based on Hering's Law of Cure: the Hering's Law Assessment Tool (HELAT)

Introduction: Hering’s ‘Law of Cure’ is considered important in homeopathy andthought to predict a positive outcome to treatment. No formal outcome measures arecurrently available to monitor response to homeopathic treatment on the basis of theseassumptions. We describe a simple assessment tool, the Hering’s Law Assessment Tool(HELAT) to identify and differentiate patient responses to homeopathic treatment as correspondingto Hering’s Law from other symptomatic responses. We describe the developmentof the tool and assess its face, content and predictive validity.Method: The HELAT was initially developed through literature review, discussion betweenhomeopaths and clinical experience. In phase one, the tool was reviewed by threeexperienced homeopaths to assess face and content validity. In phase two, we tested itspredictive validity by hypothesizing that the HELAT total score may predict changes ina clinical response (using standard validated rheumatological outcome, the AmericanCollege of Rheumatology (ACR)20%) in 32 patients with rheumatoid arthritis receivinghomeopathic intervention over 24 weeks as part of a clinical trial.Results: The HELAT was piloted and changed to improve face and content validity andthe final version was then employed for phase two as a predictor of outcome. HELAT totalscore predicted patient’s clinical response (ACR20) [B = 1.142, SE = 0.462, P = 0.013]which was independent of practitioner assessing the patients treatment response[B = 1.04, SE = 1.01, P = 0.302].Conclusion: The initial data suggests that the HELAT may hold promise for a potentialclinical and research outcome measure in homeopathy. Further work is now needed toformally assess its reliability and validity for potential use in clinical practice and trials