Context.— Since 2008, the Northern Territory Point-of-Care Testing Program has improved patient access to pathology testing for acute and chronic disease management for remote health services. Objective.— To evaluate the analytical quality, service delivery, and clinical utility of an expanding remote point-of-care testing network. Design.— Four years (2016–2019) of data on analytical quality, test numbers, and training statistics and 6 months of clinical point-of-care testing data from Abbott i-STATs at remote health services throughout the Northern Territory were analyzed to assess analytical performance, program growth, and clinical utility. Results.— From 2016 to 2019, point-of-care test numbers increased, with chemistry and blood gas testing more than doubling to 8500 and 6000 tests, respectively, troponin I testing almost doubling (to 6000), and international normalized ratio testing plateauing at 8000 tests. Participation in quality control and proficiency testing was high, with quality comparable to laboratory-based analytical goals. A shift toward flexible training and communication modes was noted. An audit of point-of-care test results demonstrated elevated creatinine, associated with chronic kidney disease management, as the most common clinically actionable patient result. Conclusions.— The Northern Territory Point-of-Care Testing Program provides high quality point-of-care testing within remote primary health services for acute and chronic patient management and care. Clinical need, sound analytical performance, flexibility in training provision, and effective support services have facilitated the sustainability of this expanding point-of-care testing model in the remote Northern Territory during the past 11 years.

The results show that practising homeopaths may be able to correctly identify a homeopathic medicine from the set of symptoms generated during an HPT. This suggests that such symptom pictures generated by taking an ultramolecular homeopathic medicine are recognisable and specific to the substance taken. Since identification of the remedy was based on past HPT information held in the materia medica, this demonstrates that HPT-generated symptom pictures are reproducible, thus validating the HPT methodology. These promising preliminary findings warrant replication; possible improvements to the trial design to be incorporated in future studies were identified.

We are writing in response to the study of HPTs by Dantas et al. 1 We congratulate the authors on their effort to study and advance provings, but we must express our concern about some of the conclusions in the discussion. The authors' proposition that ''the theory linking symptoms detected in healthy volunteers to those treated in the sick is wrong,'' flies in the face of everything homeopathy represents.While we believe that it is worthwhile to explore the issues raised by provings through a research model because it invites academic debate and further study, we are concerned with some of the comments in the related guest editorial. It is surprising to read the statement, ''Despite a lot of effort, it remains very uncertain that HPTs yield valid results, capable of contributing to the cure of disease''. 2 It seems as if the guest editor is suggesting that none of our remedies work in practice. This is perplexing because we presume that he commonly uses Staphysagria, Aurum or Sulphur and perhaps on occasion, some modern proved remedies. It is one thing to raise controversial questions by publishing original research, but quite another for an editorial in a respected homoeopathic journal to so strongly condemn the historical provings on which our profession is based and which have proved themselves in millions of cases.We are keenly interested in how conventional scientific methodology can realistically study homoeopathy while maintaining its integrity and one of us (JS) has experience of conducting over 30 homoeopathic provings. From this perspective, we would like to offer the following further comments on the study and editorial.1. It is disappointing that the authors chose to study provings from 1945 to 1995 as this is well known as the weakest period of homoeopathic provings, both in quality and quantity. Using these low quality provings as a yardstick to invalidate homoeopathic provings as a whole is seriously biased.While admitting that HPT methodology has improved with each decade since 1945, the authors have chosen a cutoff point of 1995. In fact there was a renaissance of provings utilizing rigorous methodology following the 1994 publication of The Dynamics and Methodology of Provings which recommended exacting standards, including monitored pre-observation baseline, blinding of provers and supervisors, use of placebo, clear instructions to provers and supervisors, close supervision of provers, specific guidelines for selection of symptoms, and high ethical standards, as suggested by the study authors in their conclusion. 3 Unfortunately, because of the timeframe of the study, the authors have disregarded these improvements in modern proving methodology.2. One of the most disconcerting conclusions of the authors is that historical provings, including Hahnemann's, are flawed in methodology, are unable to withstand statistical analysis for reliability and therefore produce symptoms that are unreliable in treating patients homoeopathically.We find this a rash conclusion on the part of the authors. In the a...

No abstract