NLH - Complementary and Alternative Medicine:
"The library aims to include the best available evidence for complementary and alternative medicine and will be updated regularly. At present it includes Cochrane systematic reviews, other systematic reviews which have been appraised and included on the Database of Abstracts of Reviews of Effects (DARE), and Clinical Evidence reviews focusing on specific CAM interventions for various medical conditions."
Showing posts with label Complementary Medicine. Show all posts
Showing posts with label Complementary Medicine. Show all posts
Saturday, May 20, 2006
Friday, July 15, 2005
Complemetary Medicine and Internet healthcare
Complemetary Medicine and Internet healthcare
"Whenever you use the internet for information on complementary medicine, remember my motto - if it sounds too good to be true, it probably is."
Edzard Ernst is professor of complementary medicine at the Peninsula medicine school at the universities of Exeter and Plymouth.
"Whenever you use the internet for information on complementary medicine, remember my motto - if it sounds too good to be true, it probably is."
Edzard Ernst is professor of complementary medicine at the Peninsula medicine school at the universities of Exeter and Plymouth.
Wednesday, September 08, 2004
Monday, May 17, 2004
Homeopathy?
I've been trying and trying to find reasons for if and why this works. This is because my mind finds it really difficult to comprehend and believe something when it doesn't make sense. Maybe one day I'll go on a course and just rote learn all the theories. Acupuncture made some sense to me, as does herbalism and osteopathy. But sitting in on Traditonal Chinese Medicine doctors' consultations was one of the spookiest things I ever did. Maybe in a hundred years this will be more popular than modern medicine, but I think lots of us still need more convincing. I've found one study in the New Scientist but I find this hard to believe. As a colleague pointed out:
# it implies disaster would strike if the homeopathic solution would fall into a river. It would just be too powerful.
# how do the industrial scale factory produced homeopathic medicines sit with the idea of a personalised homeopathic prescription?
# how do you wash out your bottles after making up your homeopathic mixtures? (Each time you try to wash it, the residual traces of medicine would only become more "potent"!)
# how is homeopathy meant to have a "good" but not a "bad" effect? (How does the remedy know when to stop suppressing or stimulating the coagulation system say when it is at the optimum level for health?)
# if you were to make up a serial dilution of say 100 different homeopathic remedies, to a dilution below Avagadro's number, then how could you tell them apart? (If the labels were removed!) Could anyone, or any test, scientific or homeopathic tell them apart with an accuracy greater than chance?
But, I suppose, it apparently does work for some people.
# it implies disaster would strike if the homeopathic solution would fall into a river. It would just be too powerful.
# how do the industrial scale factory produced homeopathic medicines sit with the idea of a personalised homeopathic prescription?
# how do you wash out your bottles after making up your homeopathic mixtures? (Each time you try to wash it, the residual traces of medicine would only become more "potent"!)
# how is homeopathy meant to have a "good" but not a "bad" effect? (How does the remedy know when to stop suppressing or stimulating the coagulation system say when it is at the optimum level for health?)
# if you were to make up a serial dilution of say 100 different homeopathic remedies, to a dilution below Avagadro's number, then how could you tell them apart? (If the labels were removed!) Could anyone, or any test, scientific or homeopathic tell them apart with an accuracy greater than chance?
But, I suppose, it apparently does work for some people.
Friday, May 14, 2004
Placebo, good or bad?
I'm trying to decide whether I like these or not.
I think I rather like the idea of a placebo. Sometimes, when a patient attends, you know they have nothing specific wrong, but they so want to take something to make them feel a little better. Some of my senior colleagues have dished out "tonics" to these patients, and the patients love them. "Oh I don't know what was in that medicine doctor but after taking it I feel much better". Nowadays though, I might get struck off for doing something like this. Or, with my luck, the patient's grandson will be a medical student or the patient will turn out to be the local pharmacist, and will corner me later to ask what on earth have I been prescribing and hadn't I better start prescribing proper medicines with some daleel behind them...
But, if the patient goes along and sees a practitioner of alternative medicine (something more and more GPs are now getting their hands into in the UK), they'll tell them what it is that's wrong, and prescribe a little bottle of something, and it'll have the same effect as the tonics. So they'll come back and tell me and I'll think again about why the "evidence based" health care system that I work for isn't doing me any favours.
However, when one of my relatives goes to see one of these people and pays an arm and a leg to get the little bottle of nothing, this I can't take. It just seems a mockery of good science, so this, I know, I would hate from the bottom of my nafs.
So in conclusion I think they are rather unethical.
What's wrong with the placebo effect?
I think I rather like the idea of a placebo. Sometimes, when a patient attends, you know they have nothing specific wrong, but they so want to take something to make them feel a little better. Some of my senior colleagues have dished out "tonics" to these patients, and the patients love them. "Oh I don't know what was in that medicine doctor but after taking it I feel much better". Nowadays though, I might get struck off for doing something like this. Or, with my luck, the patient's grandson will be a medical student or the patient will turn out to be the local pharmacist, and will corner me later to ask what on earth have I been prescribing and hadn't I better start prescribing proper medicines with some daleel behind them...
But, if the patient goes along and sees a practitioner of alternative medicine (something more and more GPs are now getting their hands into in the UK), they'll tell them what it is that's wrong, and prescribe a little bottle of something, and it'll have the same effect as the tonics. So they'll come back and tell me and I'll think again about why the "evidence based" health care system that I work for isn't doing me any favours.
However, when one of my relatives goes to see one of these people and pays an arm and a leg to get the little bottle of nothing, this I can't take. It just seems a mockery of good science, so this, I know, I would hate from the bottom of my nafs.
So in conclusion I think they are rather unethical.
What's wrong with the placebo effect?
Wednesday, April 21, 2004
Complementary and Alternative Therapies
"My auntie was under the doctor for six months, but it was only when she started on homeopathy that she got better".
Many of our friends and patients are interested in this area. Some of them have tried Western Medicine, some haven't. Umm Ilhaam is of the opinion that although some of these therapies may work (found by experimenting on close family members!), for reasons known or not, certainly not all of them do. At the end of the day though, we feel its good to see some evidence. That's where Bandolier comes in.
Have you ever thought about why bogus remedies seem to work? If so, then here's something to think about.
"#Many diseases are self-limiting
The old saying is that a cold will go away in a week or in seven days if you treat it. Determining whether an intervention has made a difference is therefore difficult. Unless rigorous study methods are applied, an apparent benefit cannot be ascribed to the intervention or the natural course of the disease.
#Many diseases are cyclical
Allergies, multiple sclerosis, arthritis and gastrointestinal problems like irritable bowel syndrome all have their ups and downs. Sufferers may seek therapy on a down, so that when an up comes that has to be due to the therapy, doesn't it. Again, only rigorous study design combats this.
#Placebo effect
Both the above contribute to what is called a placebo effect. It can be seen as the natural course of things. For instance, some people need no pain relief after surgery, making a pre-emptive intervention which claims to reduce pain after surgery a sure win. There will always be some people publicly to declaim its value. Natural "placebo" rates depend on what the problem is and what the benefit is. There will always be some people who benefit without an intervention.
#Bets are "hedged"
"My auntie was under the doctor for six months, but it was only when she started on homeopathy that she got better". The fact that the poor infantry slaved away for six months is forgotten in the glamour of magic.
#Original diagnosis may be wrong
Bandolier has highlighted the difficulty of diagnosis. If the diagnosis is wrong, then miraculous cures are less miraculous.
#Mood improvement or cure
Alternative healers often have much more time to spend with their patient than a harassed GP loaded down with kilograms of guidelines and tight prescribing budgets. Is it any wonder that alternative healers can make patients feel better? That mood change is sometimes seen as the cure.
#Psychological investment in alternatives
Alternative healing can be as simple as some herbal remedy bought from a shop. Sometimes it can involve huge amounts of time, massive involvement of the family, and an intense psychological investment in believing that something (anything) will work. It is not surprising, then, that many people find some redeeming value in the treatment."
http://www.jr2.ox.ac.uk/bandolier/booth/booths/altmed.html
Many of our friends and patients are interested in this area. Some of them have tried Western Medicine, some haven't. Umm Ilhaam is of the opinion that although some of these therapies may work (found by experimenting on close family members!), for reasons known or not, certainly not all of them do. At the end of the day though, we feel its good to see some evidence. That's where Bandolier comes in.
Have you ever thought about why bogus remedies seem to work? If so, then here's something to think about.
"#Many diseases are self-limiting
The old saying is that a cold will go away in a week or in seven days if you treat it. Determining whether an intervention has made a difference is therefore difficult. Unless rigorous study methods are applied, an apparent benefit cannot be ascribed to the intervention or the natural course of the disease.
#Many diseases are cyclical
Allergies, multiple sclerosis, arthritis and gastrointestinal problems like irritable bowel syndrome all have their ups and downs. Sufferers may seek therapy on a down, so that when an up comes that has to be due to the therapy, doesn't it. Again, only rigorous study design combats this.
#Placebo effect
Both the above contribute to what is called a placebo effect. It can be seen as the natural course of things. For instance, some people need no pain relief after surgery, making a pre-emptive intervention which claims to reduce pain after surgery a sure win. There will always be some people publicly to declaim its value. Natural "placebo" rates depend on what the problem is and what the benefit is. There will always be some people who benefit without an intervention.
#Bets are "hedged"
"My auntie was under the doctor for six months, but it was only when she started on homeopathy that she got better". The fact that the poor infantry slaved away for six months is forgotten in the glamour of magic.
#Original diagnosis may be wrong
Bandolier has highlighted the difficulty of diagnosis. If the diagnosis is wrong, then miraculous cures are less miraculous.
#Mood improvement or cure
Alternative healers often have much more time to spend with their patient than a harassed GP loaded down with kilograms of guidelines and tight prescribing budgets. Is it any wonder that alternative healers can make patients feel better? That mood change is sometimes seen as the cure.
#Psychological investment in alternatives
Alternative healing can be as simple as some herbal remedy bought from a shop. Sometimes it can involve huge amounts of time, massive involvement of the family, and an intense psychological investment in believing that something (anything) will work. It is not surprising, then, that many people find some redeeming value in the treatment."
http://www.jr2.ox.ac.uk/bandolier/booth/booths/altmed.html
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