Multidimensional Validation of the Patient Response Assessment Tool after Homoeopathic Treatment (PRATHoT, version 2.0): A Longitudinal Predictive Modeling Study of a Decision Tree Hierarchy in Chronic Diseases
Taniya Islam, Sangita Saha, Subhasish Ganguly, Pulakendu Bhattacharya, Satyajit Naskar, Joynab Khatun, Anil Kumar Mandi, Preeti Bhandari, Sutapa Dutta, Munmun Koley, Subhranil SahaAbstract
Background:
Assessing clinical progress in homoeopathy demands standardized tools aligned with patient-reported outcomes.
Objective:
This study presents the formal quantitative validation of the Patient Response Assessment Tool after Homoeopathic Treatment (PRATHoT) version 2.0, a clinical coding system for chronic disease management.
Methods:
We conducted a prospective longitudinal validation study with 604 participants across various chronic diseases, treated with individualized homoeopathic medicines (IHMs) in centesimal potencies. Outcomes included the Outcome Related to Impact on Daily Living (ORIDL) and Measure Yourself Medical Outcome Profile version 2.0 (MYMOP-2). Validation comprised internal (decision tree [DT] analysis, 10-fold cross-validation, variable importance, permutation testing with 1000 iterations) and external strands (multivariable logistic regression, calibration plots, decision curve analysis, generalized linear mixed models against ORIDL and MYMOP-2).
Results:
Responses were captured from 604, 587, and 547 patients over three consecutive months via probabilistic systematic sampling. Medicinal, disease, and homoeopathic aggravations occurred on 5, 4, and 25 occasions, respectively, with 56% of homoeopathic aggravations in month 1. Predictive precision improved progressively; by month 3, the model showed excellent discrimination (area under the curve: 0.961; 95% confidence interval: 0.95–0.98) and near-perfect calibration (slope: 1.0; intercept < 0.0001). DT analysis pinpointed ORIDL as the predictor of curative responses, with node purity rising to 95.8% accuracy at final follow-up. Reclassification (NRI/IDI) affirmed the value of multi-instrument integration (
Conclusions:
PRATHoT version 2.0 proved mathematically stable, clinically precise, and well-calibrated decision-tree framework to predict homoeopathic responses in chronic diseases.