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From: Patricia Anderson <[log in to unmask]>
To: [log in to unmask]
Sent: Friday, 21 September 2012, 22:18
Subject: Re: Complimentary Medicine - Absence of proof is not proof of absence

I must agree with Kamlesh on this. A few months ago someone who
purports to be a proponent of evidence-based research in healthcare
jumped all over me for posting a link to an article about a CAM
methodology. The article was peer-reviewed and a randomized controlled
clinical trial. I reviewed the methodology myself and found it sound,
likewise the sample size and analysis seemed appropriate, and findings
were conservatively presented. His argument against the article was
the journal in which it was published, which was automatically "bad"
because the journal often published CAM articles. We learn nothing
from that sort of argument, which will persuade no one except those
who have already made up their mind.

It is incredibly difficult to prove a negative, to prove that
something is NOT true. With evidence-based research, as I was told
over and over by my mentor in EBHC, the most you can ever say to
approach a negative is that there is insufficient evidence. You cannot
say the approach or methodology are false or don't work; but you can
say that there is not enough evidence to say it is true. There are
innumerable examples of past science saying something is false, and
then later we thought up some clever approach that opened the door to
new understanding. Closing that door simply means you've given up, not
that there is nothing there to learn.  I strongly emphasize this when
I am teaching on this subject.

We support a program here on Complementary and Alternative Medicine
(CAM). A few of the publicly available resources we recommend for them
are CIMER, About Herbs, and NCCAM, each of which includes evidence
based information in their overviews.

CIMER (Complementary/Integrative Medicine Education Resources)
<http://www.mdanderson.org/education-and-research/resources-for-professionals/clinical-tools-and-resources/cimer/index.html>

MSKCC: About Herbs (About Herbs, Botanicals & Other Products)
<http://www.mskcc.org/cancer-care/integrative-medicine/about-herbs-botanicals-other-products>

National Center for Complementary and Alternative Medicine (NCCAM)
<http://nccam.nih.gov>
NCCAM Health Info: <http://nccam.nih.gov/health>

MedlinePlus also makes available a subset of Natural Standard, a
commercially available database on the topic. Our institution pays for
full access, so we don't often recommend it to our students, however,
this is very helpful for the general public, since the information is
so thoroughly vetted.

MedlinePlus: Herbs and Supplements
<http://www.nlm.nih.gov/medlineplus/druginfo/herb_All.html>

I would also recommend the following resources.

NOAH: Evidence-based CAM
<http://www.noah-health.org/en/alternative/resources/ecam.html>

Oxford Press: Evidence-based Complementary and Alternative Medicine (eCAM)
<http://www.oxfordjournals.org/our_journals/ecam/for_authors/scope.html>

Sage Publications: Journal of Evidence-Based Complementary &
Alternative Medicine (JEBCAM) (formerly Complementary Health Practice
Review)
<http://chp.sagepub.com>

University of Washington: LibGuide: Evidence-based Complementary and
Alternative Medicine (CAM)
<http://libguides.hsl.washington.edu/cam>


- Patricia

On Fri, Sep 21, 2012 at 4:19 PM, Kamlesh Bhargava <[log in to unmask]> wrote:
> Dear List members,
>
> At the outset must admit that we do not teach complimentary medicine to our
> undergraduates.
>
> In fact the terms have graduated from "Alternative medicine" to
> "Complimentary Medicine" to "Integrative Medicine" and soon we will have
> more of "Epigenetics" which to an extent covers the biopsychosocial aspects.
>
> Whatever we may say or do, our patients do believe in other forms of
> treatment, spend out of their pockets. So we should know more about it.
>
> I a interested in Evidence based Integrative Medicine and would like to
> collaborate with people interested in this feild.
>
> As a begining  our postgraduates in Family Medicine whenever they come
> accross a patient who is taking "Complimentary medicine" we ask them to
> search for the evidence and are surprised to see published evidence.
>
> Where to begin with there are 2 books which have incorporated evidence
>
> Integrative Medicine by David Rakel
> Oxford Handbook of Complimentary Medicine by Edward Ernst et Al
>
> Finally as they say "The mind is like a parachute it works best when open"
> so also we need to consider factors like "Expectations of patients" and
> "Experience of doctors/patients" not only "Evidence" because the The absence
> of proof is not the proof of absence (Prof. Kameshwar Prasad loves this
> quote and gives the example of OJ Simson trial)
>
> Best wishes.
>
>
> On Wed, Sep 19, 2012 at 1:43 AM, Margaret MacDougall <[log in to unmask]>
> wrote:
>>
>> Dear list members
>>
>> As a non-clinician, I would like to improve my understanding of current
>> perspectives in different countries on the teaching of the principles and
>> practise of complementary medicine to undergraduate medical students. Do
>> perspectives vary across countries and are their instances where such
>> teaching is taboo?
>>
>> Best wishes
>>
>> Margaret
>
>
>
>
> --
> Dr. Kamlesh Bhargava FRCGP [INT]
> Senior Consultant
> Dept. of Family Medicine & Public Health
> College of Medicine
> Sultan Qaboos University
>
> Program Director
> Family Medicine Residency Training Program
> Oman Medical Specialties Board
> Oman
>
> Office +968 2414158/24147208
> Mobile +968 99369015
> [log in to unmask]
>
>



--
Patricia Anderson, [log in to unmask]
Emerging Technologies Librarian
University of Michigan
http://www.lib.umich.edu/users/pfa