Fundamental principles for the evaluation of medicinal and non-medicinal therapies: A framework for assessing self-healing processes

Methods for evaluating the effects of drugs remain an essential scientific reference. Awareness of the importance of non-specific efficacy factors in medicinal and non-medicinal therapeutic interventions raises the question of how these factors can be harnessed, particularly in the care relationship. Reflections on self-healing processes highlight the importance of a specific methodological framework, which forms the subject of this article.
We examine the main features of the evaluation methodology and their specific role in controlling confounding factors and biases. This analysis allows us to propose a framework for evaluating the therapeutic interventions and associated components involved in self-healing processes, such as the placebo effect.
Our analysis sheds light on the consequences of open-label evaluation, leading to the proposal of a new level of evidence scale for the efficacy of therapeutic approaches, as well as a procedure to personalizing the estimation of the benefit of an intervention resulting from therapeutic trials. The new scale separates the contribution of meta-analyses and clinical trials, and emphasizes the importance of conducting blinded evaluation trials.
The proposed evaluation framework provides common references for working on self-healing and its mechanisms or components. This framework should be tested in future work at the Institut de Recherche Indépendant sur l’Autoguérison (IRIA) (Independent Research Institute for Self-Healing).