How Much of CAM Is Based on Research Evidence?

The aim of this article is to provide a preliminary estimate of how much CAM is evidence-based. For this purpose, I calculated the percentage of 685 treatment/condition pairings evaluated in the “Desktop Guide to Complementary and Alternative Medicine” which are supported by sound data. The resulting figure was 7.4%. For a range of reasons, it might be a gross over-estimate. Further investigations into this subject are required to arrive at more representative figures

Dismantling yhe rhetoric of alternative medicine : smokescreens, errors, conspiracies, and follies

Alternative medicine has a high social prevalence, being promoted by well organized groups that have developed an intricate rhetoric in order to self-justify in the absence of evidence. This article will analyse some of these arguments, some of their fallacies ??ad populum, ad ignorantiam??, other styles of reasoning ??conspiracy theories?? and other misconceptions of scientific concepts ??placebo effect, scientific authority. The objective will be to highlight the poverty of the rhetoric of proponents of alternative medicine, with special emphasis on the dangers for the consumer

Why homoeopathy is pseudoscience

Homoeopathy is commonly recognised as pseudoscience. However, there is, to date, no systematic discussion that seeks to establish this view. In this paper, we try to fill this gap. We explain the nature of homoeopathy, discuss the notion of pseudoscience, and provide illustrative examples from the literature indicating why homoeopathy fits the bill. Our argument contains a conceptual and an empirical part. In the conceptual part, we introduce the premise that a doctrine qualifies as a pseudoscience if, firstly, its proponents claim scientific standing for it and, secondly, if they produce bullshit to defend it, such that, unlike science, it cannot be viewed as the most reliable knowledge on its topic. In the empirical part, we provide evidence that homoeopathy fulfils both criteria. The first is quickly established since homoeopaths often explicitly claim scientificity. To establish the second, we dive into the pseudo-academic literature on homoeopathy to provide evidence of bullshit in the arguments of homoeopaths. Specifically, we show that they make bizarre ontological claims incompatible with natural science, illegitimately shift the burden of proof to sceptics, and mischaracterise, cherry-pick, and misreport the evidence. Furthermore, we demonstrate that they reject essential parts of established scientific methodology and use epistemically unfair strategies to immunise their doctrine against recalcitrant evidence

Prevalence of Complementary and Alternative Medicine-use by UK Cancer Patients: A Systematic Review of Surveys

This is a freely-available open access publication. Please cite the published version which is available via the DOI link in this record.Background: Cancer patients seem to frequently use Complementary and Alternative Medicine (CAM). However, estimates of the level of usage vary widely. This systematic review is aimed at determining the prevalence of CAM-use in cancer patients of the United Kingdom (UK). Method: Five databases were searched for English language peer-reviewed surveys published between 01 January 2000 and 07 October 2011. In addition, relevant book chapters and our own departmental files were handsearched. Results: 25 surveys were included with a total sample size of 6798. Across all studies, the median prevalence rate of CAM-use was 30.5 (standard deviation=10.3). Herbal medicine was the most popular CAM modality, followed by homeopathy, aromatherapy, reflexology and relaxation. Conclusions: Many UK cancer patients use CAM. Oncologists need to be aware of these numbers as they can impact daily practice on the management of cancer patients

Problems with ethical approval, and how to fix them:lessons from three trials in rheumatoid arthritis

Jonathan Mendel and colleagues call for greater transparency on ethics committee decisions to improve trial design

The evidence-base for complementary medicine in children: a critical overview of systematic reviews

Background: the use of complementary and alternative medicine (CAM) in paediatric populations is common yet, to date, there has been no synthesis of the evidence of its effectiveness in that population. This overview of systematic review evaluates the evidence for or against the effectiveness of CAM for any childhood condition.Methods: Medline, AMED and Cochrane were searched from inception until September 2009. Reference lists of retrieved articles were hand-searched. Experts in the field of CAM were contacted. No language restrictions were applied.Results: 17 systematic reviews were included in this overview, covering acupuncture, chiropractic, herbal medicine, homeopathy, hypnotherapy, massage and yoga. Results were unconvincing for most conditions although there is some evidence to suggest that acupuncture may be effective for postoperative nausea and vomiting, and that hypnotherapy may be effective in reducing procedure-related pain. Most of the reviews failed to mention the incidence of adverse effects of CAMs.Conclusions: although there is some encouraging evidence for hypnosis, herbal medicine and acupuncture, there is insufficient evidence to suggest that other CAMs are effective for the treatment of childhood conditions. Many of the systematic reviews included in this overview were of low quality, as were the randomised clinical trials within those reviews, further reducing the weight of that evidence. Future research in CAM for children should conform to the reporting standards outlined in the CONSORT and PRISMA guideline

Cost-Effectiveness of Complementary Therapies in the United Kingdom—A Systematic Review(†)

Objectives: The aim of this review is to systematically summarize and assess all prospective, controlled, cost-effectiveness studies of complementary therapies carried out in the UK. Data sources: Medline (via PubMed), Embase, CINAHL, Amed (Alternative and Allied Medicine Database, British Library Medical Information Centre), The Cochrane Library, National Health Service Economic Evaluation Database (via Cochrane) and Health Technology Assessments up to October 2005. Review methods: Articles describing prospective, controlled, cost-effectiveness studies of any type of complementary therapy for any medical condition carried out in the UK were included. Data extracted included the main outcomes for health benefit and cost. These data were extracted independently by two authors, described narratively and also presented as a table. Results: Six cost-effectiveness studies of complementary medicine in the UK were identified: four different types of spinal manipulation for back pain, one type of acupuncture for chronic headache and one type of acupuncture for chronic back pain. Four of the six studies compared the complementary therapy with usual conventional treatment in pragmatic, randomized clinical trials without sham or placebo arms. Main outcome measures of effectiveness favored the complementary therapies but in the case of spinal manipulation (four studies) and acupuncture (one study) for back pain, effect sizes were small and of uncertain clinical relevance. The same four studies included a cost-utility analyses in which the incremental cost per quality adjusted life year (QALY) was less than £10 000. The complementary therapy represented an additional health care cost in five of the six studies. Conclusions: Prospective, controlled, cost-effectiveness studies of complementary therapies have been carried out in the UK only for spinal manipulation (four studies) and acupuncture (two studies). The limited data available indicate that the use of these therapies usually represents an additional cost to conventional treatment. Estimates of the incremental cost of achieving improvements in quality of life compare favorably with other treatments approved for use in the National Health Service. Because the specific efficacy of the complementary therapies for these indications remains uncertain, and the studies did not include sham controls, the estimates obtained may represent the cost-effectiveness non-specific effects associated with the complementary therapies

The Use of Garcinia Extract (Hydroxycitric Acid) as a Weight loss Supplement: A Systematic Review and Meta-Analysis of Randomised Clinical Trials

The aim of this systematic review is to examine the efficacy of Garcinia extract, hydroxycitric acid (HCA) as a weight reduction agent, using data from randomised clinical trials (RCTs). Electronic and nonelectronic searches were conducted to identify relevant articles, with no restrictions in language or time. Two independent reviewers extracted the data and assessed the methodological quality of included studies. Twenty-three eligible trials were identified and twelve were included. Nine trials provided data suitable for statistical pooling. The meta-analysis revealed a small, statistically significant difference in weight loss favouring HCA over placebo (MD: −0.88 kg; 95% CI: −1.75, −0.00). Gastrointestinal adverse events were twice as common in the HCA group compared with placebo in one included study. It is concluded that the RCTs suggest that Garcinia extracts/HCA can cause short-term weight loss. The magnitude of the effect is small, and the clinical relevance is uncertain. Future trials should be more rigorous and better reported

Effects of moxibustion for constipation treatment: a systematic review of randomized controlled trials

Several studies reported that moxibustion was effective in treating constipation. This systematic review assesses the clinical evidence for or against moxibustion for treating constipation. Twelve databases were searched from their inception to March 2010. Only randomized clinical trials (RCTs) were included if they compared moxibustion with placebo, sham treatment, drug therapy or no treatment. The methodological quality of these RCTs was assessed with the Cochrane risk of bias analysis. All three RCTs included in the study had a high risk of bias. Two included studies found favorable effects of moxibustion. The third RCT showed significant effects in the moxibustion group. Given that the methodological quality of all RCTs was poor, the results from the present review are insufficient to suggest that moxibustion is an effective treatment for constipation. More rigorous studies are warranted