By George Thomas Lewith MA DM FRCP MRCGP, Wayne B. Jonas MD, Harald Walach Dip Psych PhD
There's a substantial and extending curiosity in learn regarding complementary remedies to set up a base of study effects with a view to aid perform. despite the fact that, no longer all cures may be taken care of an analogous approach, both from a similar viewpoint of what healthiness and therapy are, or channelled in the course of the technique of randomized, managed trials. This booklet analyzes the main questions usually requested and the controversies debated in complementary drugs learn, and provides transparent tips written by means of specialists during this box.
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Extra info for Clinical Research in Complementary Therapies: Principles, Problems and Solutions
American Psychological Association, Washington DC Kirsch I, Sapirstein G 1998 Listening to prozac but hearing placebo: a meta-analysis of antidepressant medication. Prevention and Treatment 1 Kleinman A, Eisenberg Let al1978 Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Annals of Internal Medicine 88(2): 251-258 Lao L 1999 Traditional Chinese Medicine. In: Jonas WB, Levin JS (eds) Essentials of complementary and alternative medicine. Lippincott Williams and Wilkins, Philadelphia.
Therefore, although CAM interventions are purportedly based on specific interventions, a variety of these theories might be incorrect. Most of what CAM practitioners do might relate to the non-specific and dynamic stimulation of a self-healing response. This, incidentally, might also be true for pharmacological interventions (Frank 1989). While specificity is theoretically the most powerful component, non-specific or synergistic effects might be the most therapeutically powerful in practice. If the questions we ask only relate to specificity, then non-specific and synergistic effects are overlooked.
It is also an important instrument in gathering data which cannot be gleaned from RCTs: data on long-term effects, on patients who do not wish to be randomized, patients with strong preferences and belief systems; in short, on typical users of CAM. Outcomes research needs RCTs in order to strengthen and qualify its results. It is not a short cut attempting to influence members of the public and purchasers but part of the landscape of evidence needed to evaluate CAM. As such, sponsors, reviewers and the scientific community at large should be urged to be more open-minded about unconventional methods for CAM research, as these are particularly needed in the evaluation of chronic illness.