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I'd like to see some evidence on the soft tissue surgeries being performed on some extremely young (< 3 y.o.) children such as achlles tendon lengthening in cerebral palsy... All evidence-based practice or evidence-disprven techniques are dependent on the interpretation of the investigator. Good research is hard to find. NK At 12:17 PM 1/30/01 +0000, you wrote: >-----Original Message----- >From: Douglas M. White [mailto:[log in to unmask]] >Sent: 30 January 2001 11:14 >To: [log in to unmask] >Subject: Re: Validity of Therapies > > >Dave: > >Yes it is another can of worms. Placebo can take many forms. PT can be >significantly more expensive in money, time and other resources than many >other types of placebo. So, shouldn't the patient or the one paying the >bills be given the option of what type of placebo, or any other treatment >for that matter, they want? Personally, if I was given the option of taking >2 pills or going to see a PT for several visits given the same benefit at a >significantly greater cost for the PT, I would take the pills. > >Then there is the whole issue of informed consent. In the US we have an >ethical and in many states a legal responsibility to obtain informed >consent. If I present a treatment option as being no better than placebo I >do not think many of my patients would agree to it. Nor would the govt. or >insurance companies pay for it. There are many other placebos that are >cheaper than PT. > >******************************************************* > > >Yes, I agree with what you say. > >Between our "non-based evidence practice" and placebo, patient should be >informed and have the choice. > >It should be the case also for surgery. We know that the question of placebo >applies also for surgery. > >The only difference is that in this medical field, lots of scientific >evidence are provided. Here, again, hypotheses are "updated" every now and >then. > >They also get "lots" of funding for their research. > >Which is not especially the case in our field or in our country. > >I am part of a research group concerning Lymphoedema treatment. >If you only knew how much we have to struggle to get some funding! >We can't wait to do our research ... but we didn't get the money-money yet. > >Life is tough. > >Noemi Lee >London UK > >http://www.noemi.freeserve.co.uk