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I think that Norman Vetter's comments raise some interesting questions whan defining 'what works'. 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. I think that you are correct that complentary medicines are often frowned upon for a variety of reasons. There is a lack of high quality evidence regarding their usage, which adds uncertainty to the question of benefit. However, many patients choose to take such therapies. In my anecdotal experience, this decision is not influenced greatly by an explicit discussion of the uncertainty of the benefits and harms of complementary therapies. 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. Peter Ellis Norman Vetter wrote: > Dear All > Forgive me being obvious but I have never seen the point of these phrases > 'alternative', 'complimentary' etc. Archie Cochrane said 'Use anything that > works'. Medicine it seems to me should include anything that works and > exclude anything that doesn't. > > The tricky bit is when we have things that don't seem to do much good or > much obvious harm, or approaches which have not yet been properly > researched, when traditional medicine has the benefit of being vaguely > understood by the establishment practitioners but non traditional does not > have that benefit. The non-traditional then has to jump through the evidence > hoops before becoming part of the establishment, whereas traditional just > sticks there 'till someone blows it out of the water. > > It's tough, but I see no easy way around it. We are gradually getting to the > sacred cows of traditional medicine (mixed metaphor heaven). > > Norman Vetter > Department of Epidemiology > UWCM > Heath Park > Cardiff CF4 4XN > 44 (0)29 20744196 > > Business Page: http://www.vetter.bizland.com/ > Homepage: http://www.uwcm.ac.uk/uwcm/ei/vetter/ > Pubwise: http://www.vetter.bizland.com/Pubwise/ > -- Peter Ellis MBBS FRACP MMed(Clin Epi)PhD Research Fellow Dept Medical Psychology Royal Prince Alfred Hospital Dept Cancer Medicine Sydney University Ph: 61 2 9515 7618 Fax: 61 2 9515 5697 email: [log in to unmask] %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%