Background: Complementary and alternative medicine is increasingly evaluated from an evidence-based medicine perspective which includes clinical trials. It was
unclear to what extent these trials represented clinical practice and assessed treatments as given in the real world. Attention deficit hyperactivity disorder (ADHD) and
homeopathy were explored as an exemplar comparing clinical trials versus daily practice. Objectives: Evaluate, contrast and compare the homeopathy as practiced within research trials with the approach adopted by practitioners in their daily practice as a treatment for children diagnosed with ADHD. Methods: An explicitly mixed methods approach based in Grounded Theory spanning quantitative and qualitative
research techniques was adopted for this project. Data elements included a systematic review, individual patient data meta-analysis, practitioner survey, in-depth
interviews and participant-observation. Each method was rigorously implemented and analysed according to best practice; the results were then synthesised to develop
an explanatory model. Results & Conclusions: Although meta-analyses suggest there is little reliable evidence in favour of homeopathy for the treatment of ADHD, the trials conducted to date do not appear to have reflected clinical practice within the UK. The diversity of practice observed presents unique challenges for researchers who wish to improve the evidence base. A model of homeopathy as a process of individualisation is offered as a starting point for documenting observational studies and developing realistic evaluations, and an outline of a future comparative trial is provided
