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Evaluating complementary medicine: methodological challenges of randomised controlled trials.

Su Mason, +2 more
- 12 Oct 2002 - 
- Vol. 325, Iss: 7368, pp 832-834
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TLDR
Complementary medicine is increasingly popular for treating many different problems, but doctors and patients need evidence about complementary treatments, but randomised controlled trials need to be carefully designed to take holism into account and avoid invalid results.
Abstract
Complementary medicine is increasingly popular for treating many different problems. Doctors and patients need evidence about complementary treatments, but randomised controlled trials need to be carefully designed to take holism into account and avoid invalid results You think that by understanding one, you can understand two, for one and one is two. But to understand two, you must first understand “and.” Sufi saying1 Complementary medicine should be evaluated as rigorously as conventional medicine to protect the public from charlatans and unsafe practices,2–5 but many practitioners of complementary medicine are reticent about evaluation of their practice. Sceptics maintain that this is because of fear that investigations will find treatments ineffective and threaten livelihoods. In defence, many practitioners argue that research methods dissect their practice in a reductionist manner and fail to take into account complementary medicine's holistic nature leading to invalid evaluation. #### Summary points Complementary medicine comprises many different disciplines, a wide spectrum of practices and philosophies which differ from conventional medicine. Conventional medicine traditionally aims to diagnose illness and treat, cure, or alleviate symptoms. Many complementary disciplines aim not only to relieve symptoms and restore wellness but also to help individuals in a process of self healing within a holistic view of health. In this view, individuals are more than just mind, body, and spirit in a social—family …

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Characteristic and incidental (placebo) effects in complex interventions such as acupuncture

TL;DR: The specific effects of non-pharmaceutical treatments are not always divisible from placebo effects and may be missed in randomised trials, so the use of placebo or sham controlled trial designs in evaluating complex non-Pharmaceutical interventions may generate false negative results.
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Is complementary and alternative medicine (CAM) cost-effective? a systematic review

TL;DR: The number and quality of economic evaluations of CAM have increased in recent years and more CAM therapies have been shown to be of good value, but the majority of CAM therapies still remain to be evaluated.
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The psychoneuroimmunological effects of music: A systematic review and a new model

TL;DR: A new model is presented which provides a framework for developing a taxonomy of musical and stress-related variables in research design, and tracing the broad pathways that are involved in its influence on the body.
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Acupuncture for Cancer-Related Fatigue in Patients With Breast Cancer: A Pragmatic Randomized Controlled Trial

TL;DR: Acupuncture is an effective intervention for managing the symptom of CRF and improving patients' quality of life in patients with breast cancer.
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Acupuncture for insomnia.

TL;DR: The current evidence is not sufficiently rigorous to support or refute acupuncture for treating insomnia, and larger high-quality clinical trials are required.
References
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Journal ArticleDOI

Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache

TL;DR: Cognitive-behavioural treatments based on the principle of cognitive behavioural therapy are effective and are associated with significant effect sizes on all domains of measurement.
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Credibility of analogue therapy rationales

TL;DR: In this article, the credibility of the rationales and procedural descriptions of two therapy, three placebo, and one component-control procedure frequently used in analogue outcome research was evaluated, and the results indicated that the control conditions were, in general, less credible than the therapy conditions.
Journal ArticleDOI

Alternative Medicine--The Risks of Untested and Unregulated Remedies

TL;DR: Alternative medicine (now often called complementary medicine) is a remarkably heterogeneous group of theories and practices — as disparate as homeopathy, therapeutic touch, imagery, and herbal medicine.
Journal ArticleDOI

Research into complementary and alternative medicine: problems and potential.

TL;DR: The growing use of unsubstantiated complementary and alternative medicine therapies by people in the United States along with its increasing coverage by third party payers encouraged Congress to create the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health to explore complementary andAlternative Medicine practices in the context of rigorous science.
Journal ArticleDOI

Integrated medicine: Imbues orthodox medicine with the values of complementary medicine

Lesley H. Rees, +1 more
- 20 Jan 2001 - 
TL;DR: Integrated medicine (or integrative medicine as it is referred to in the United States) is practising medicine in a way that selectively incorporates elements of complementary and alternative medicine into comprehensive treatment plans alongside solidly orthodox methods of diagnosis and treatment.
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