Protocol for a phase 1 homeopathic drug proving trial

<p>Abstract</p> <p>Background</p> <p>This study protocol adapts the traditional homeopathic drug proving methodology to a modern clinical trial design.</p> <p>Method</p> <p>Multi-centre, randomised, double-blind, placebo-controlled phase 1 trial with 30 healthy volunteers. The study consists of a seven day run-in period, a five day intervention period and a 16 day post-intervention observation period. Subjects, investigators and the statisticians are blinded from the allocation to the study arm and from the identity of the homeopathic drug. The intervention is a highly diluted homeopathic drug (potency C12 = 10²⁴), Dose: 5 globules taken 5 times per day over a maximum period of 5 days. The placebo consists of an optically identical carrier substance (sucrose globules). Subjects document the symptoms they experience in a semi-structured online diary. The primary outcome parameter is the number of specific symptoms that characterise the intervention compared to the placebo after a period of three weeks. Secondary outcome parameters are qualitative differences in profiles of characteristic and proving symptoms and the total number of all proving symptoms. The number of symptoms will be quantitatively analysed on an intention-to-treat basis using ANCOVA with the subject's expectation and baseline values as covariates. Content analysis according to Mayring is adapted to suit the homeopathic qualitative analysis procedure.</p> <p>Discussion</p> <p>Homeopathic drug proving trials using the terminology of clinical trials according GCP and fulfilling current requirements for research under the current drug regulations is feasible. However, within the current regulations, homeopathic drug proving trials are classified as phase 1 trials, although their aim is not to explore the safety and pharmacological dynamics of the drug, but rather to find clinical indications according to the theory of homeopathy. To avoid bias, it is necessary that neither the subjects nor the investigators know the identity of the drug. This requires a modification to the informed consent process and blinded study materials. Because it is impossible to distinguish between adverse events and proving symptoms, both must be documented together.</p> <p>Trial registration</p> <p>ClinicalTrials.gov identifier: NCT01061229.</p

Digital supply chain management in the videogames industry: a systematic literature review

As industries mature, they rely more heavily on supply chain management (SCM) to ensure effective operations leading to greater levels of organisational performance. SCM has been widely covered in many industrial areas and, in line with other burgeoning sectors such as Tourism, an industry focus provides the opportunity to look in-depth at the context-based factors that affect SCM. Developments in digital distribution and rapid technological innovations have resulted in an increased focus on Digital Supply Chains (DSCs), which bring about significant changes to how consumers, customers, suppliers, and manufacturers interact, affecting supply chain design and processes. Through a systematic review of the Videogames Industry Supply Chain Management literature, which serves as a pertinent contextual example of a DSC, we look at how supply chains are affected by structural, market and technological change, such as increased platformisation, disintermediation and the proliferation of digital distribution. We distil these findings into a new research agenda, which identifies themes in line with extant DSC research, provides a series of relevant practice recommendations and identifies opportunities for future research