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Objective: Compare a telemedical treatment (distant working) with an onsite treatment. Telemedical services have been used frequently in non-surgical disciplines. It remains unclear if orthopaedic outpatients can be treated via telemedicine. We evaluated the diagnostic accuracy and recommended therapy of a mobile healthcare communication app. Design: We conducted a prospective, double-blind, anonymized clinical study of consecutive outpatients at an orthopaedic department at a university hospital. Patients were treated by an onsite doctor, who then uploaded each patient’s variables (e.g. personal history, clinical findings, radiograph) for evaluation by a telemedical doctor. The telemedical doctor received the information only via app and did not see the patient physically. Both the onsite and telemedical doctors then uploaded their respective diagnosis and suggested therapy, blinded to each other. The patient received treatment from the onsite doctor only: virtual treatment was solely for scientific purposes and had no therapeutic impact. Results: Among 280 consecutive orthopaedic outpatients (57% female and 43% male), the mean age was 63 years. In 83% of cases, the telemedical diagnosis matched the onsite diagnosis, and in 98% of cases, the telemedical treatment did no harm. In 75% of cases, the onsite and telemedical doctors proposed the same therapy. In 2% of cases, the telemedical therapeutic regimen differed from the onsite treatment and could possibly harm the patient. Conclusion: The results suggest that diagnosis and treatment via telemedicine seems feasible in the field of orthopaedic surgery and could be an option for telemedical patient interactions (via work from home or virtual interactions).

OBJECTIVE: Use of a wheat growth bio assay after 7 days in research on homeopathic dilutions of gibberellic acid. METHODS: Grains of winter wheat (Triticum aestivum, Capo variety) were observed under the influence of extremely diluted gibberellic acid (10(-30)) prepared by stepwise dilution and agitation according to a protocol derived from homeopathy (30x). Analogously prepared water was used for control. In a two centre study, 3 experiments with a total of 4880 grains were performed. RESULTS: Data were found to be rather homogeneous within the control group as well as within the verum group in general. Germination rates were around 95%, with no significant difference between verum and control group (p>0.05). Mean stalk lengths (mm) were 40.63±20.96 for the verum and 44.33±21.11 for the control group (mean±S.D.) at grain level (N=2440 per group) and ±5.33 and ±5.89, respectively at dish level (122 cohorts of 20 grains per treatment group). In other words, verum stalk length (91.65%) was 8.35% smaller than control stalk length (100%). This difference is statistically highly significant (p<0.001) and was found by both researchers involved independently. CONCLUSION: These results suggest that there was an influence of gibberellic acid 30x on wheat seedling development, i.e. the wheat growth bio assay can be a useful tool for further experiments on homeopathic dilutions of gibberellic acid. [ABSTRACT FROM AUTHOR]

Question: Whether different homeopaths performing a repertorisation and selecting a remedy for one and the same patient would come to analogous conclusions, and whether a respective research protocol can be standardized. Methods: Homeopathic repertorisation, i.e. the technique of finding a suitable homeopathic remedy, starts with observing a patient''s symptoms. These symptoms are then compared with existing databases which were compiled by testing a remedy for its effects on healthy subjects (remedy proving). By matching the symptoms of their patient with the symptoms reported to have been provoked in healthy subjects homoeopaths are able to narrow down the number of candidate remedies (a) to a few or, in the ideal case, (b) to the one best fitting remedy (the similimum). The outcome is influenced by the therapist''s experience and the quality of the databases used. The purpose of this study was to determine whether or to what degree different persons performing a repertorisation for one and the same patient come to analogous conclusions. Homeopathy students were asked to study video-documented case-takings. As a rule 8 students each studied 5 case-takings. Each student independently (a) performed his or her own repertorisation to narrow down the number of candidate remedies and (b) finally selected one single remedy. A computer-assisted repertory (Radar) comprising 4497 possible remedies was used. Inter-rater reliability was expressed in terms of Cohen''s kappa (0=no agreement, 1=full agreement). Results: [(A)] In each of the 5 cases a list of the 10 highest-ranking remedies was generated from the students’ repertorisations. The first-ranking remedy was selected on average by 70% of the students, the second by 57%, 3rd: 45%, 4th: 31%, 5th: 28%, 6th: 22%, 7th: 22%, 8th: 19%, 9th: 15%, 10th: 13% (selection of more than one remedy was permitted). Cohen''s kappa for the students’ inter-rater reliability was 0.33/0.24/0.43/0.33/0.22, giving an arithmetic mean of 0.309. [(B)] When students were asked to select a single remedy for each of the 5 cases the first-ranking remedy was selected by 48%, 2nd: 35%, 3rd: 7%, 4th: 7%, 5th: 2%, 6thff: 0% (selection of only one remedy permitted). Inter-rater reliability was 0.21/0.24/0.43/0.38/0.31, giving a mean of 0.312. Conclusion: The experimental design presented here should be further investigated by experienced homeopaths. [Copyright &y& Elsevier]

Question: To standardise a statistical approach to comparing relative differences in homoeopathy research. Background: Betti et al. (1997) and Brizzi et al. (2005) reported a stimulation of the longitudinal growth of wheat stalks through treatment of the seeds with high potencies of arsenic. On replicating the experiment however, Binder et al. (2005) found a significant decrease in longitudinal growth. Hamann et al. (2003) described biphasic effects of seed germination under high dilutions of gibberellic acid. Several independent researchers working at the Interuniversity College found significantly reduced longitudinal growth of wheat stalks in groups treated with gibberellic acid 30× (stepwise diluted and succussed, 10e–30: G 30×) as compared with groups treated with water 30× (W 30×) when experiments were performed in autumn or spring. However, replications of this experiment in winter produced higher values in the G 30× groups. From this one could draw the global conclusion that the G 30× model is not reliably reproducible and that G 30× and W 30× do not differ for all data pooled. On the other hand, the data appear too well ordered to allow the conclusion that the tested substance(-s) have no effect. On the contrary, there does appear to be an effect, and it even proves to be statistically homogeneous within the individual trials. Methodological proposal: To date the results obtained with this model have been analysed by means of variance analyses comparing the growth rates under G 30× and W 30×. Variance analyses were also performed to compare growth within the individual trials and within the G 30× and the W 30× group. For future evaluations we propose using the relative difference between groups as an absolute value for the following calculations, regardless of which group showed more growth. This may permit a more meaningful interpretation of seemingly contradictory results as they are so often observed in homoeopathy research. Our interpretation of the botanical trials is that G 30× (and possibly also W 30×) gives a physiological stimulus which the organism may respond to in different directions. [Copyright &y& Elsevier]