More trials, fewer placebos, please

The argument that randomized placebo-controlled trials of homeopathy might usefully be replaced by observational studies, audit and quality-of life assessment is considered. Randomized equivalence and patient-preference trials are proposed as more informative alternatives. They have the merit of providing hard information for health services on the comparative value of treatments, and can facilitate internal comparisons of competing homeopathic methods. The pragmatic approach also allows clinical change during the homeopathic treatment of chronic disease to be assessed without the time constraints usually imposed by placebo controls.