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The difficulty here is defining the outcome of interest. In oncology the use of
complementary therapies is high. Trials of 'traditional medicines' have focused
on 'hard' outcomes such as survival or more recently time to disease
progression. However there may be other outcomes which are important to
individual patients.
We need better evidence regarding what 'works'. However I feel that patient
focused outcomes need to be considered so that we ask the right questions.
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It seems there are several issues here. First, it is certainly true that many
RCT's of "conventional" therapy did not report a variety of outcomes that may
be important to patients, e.g., health status, quality of life, symptoms, etc.
etc. Further,although the technology is imperfect, there are methods available
to measure such outcomes, from generic scales like the SF-36 through disease
specific methods, to patient specific methods like utility assessment. So
ideally, before doing a RCT of "conventional" therapy, one should consider
all the possible outcomes of that therapy, good and bad, that might matter to
patients, and try to assess these outcomes.
Having said this, at least in oncology (and other fields) many trials have
been done which at least show the effects of the treatments on some outcomes.
Of course, it does not make sense to say a treatment probably improves
quality of life merely because it improves quantity of life. On the other
hand, most "complementary" therapies have never been subject to any sort of
trial. It makes less sense to say a treatment probably improves quality of
life in the absence of any good evidence about its effects on any outcomes.
But for some reason, there seems to be some sort of double standard for
complementary therapy that allows claims about improvement in quality of
life to be taken more seriously by some people than such claims about
conventional therapy. Perhaps this involves what psychologists call magical
thinking, but magical thinking rarely leads to good decisions.
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