Excellent find! I find a huge part of the problem in discussing CAM is that so many of the people vilifying it actually don't know anything about it, and can't tell the difference between homeopathy and herbals or the rest of the CAM options. They lump it all into one giant bag, and beat it with a stick. While I suspect this author similarly doesn't know much about homeopathy (nor do I frankly, but I know enough to have an idea what I don't know), I like his idea that we should focus on fixing what's not working in our own practice (medical errors, for example, or misdiagnosis, or side effects) and if it isn't hurting folk, leave it alone.- PatriciaOn Sat, Sep 22, 2012 at 2:16 PM, Jim Henderson, Mr. <[log in to unmask]> wrote:
Recent addition to the discussion from this week's BMJ:
Good medicine: homeopathy
Des Spence
BMJ 2012;345:e6184 (Published 14 September 2012)
Jim
+++++++++++++++++++++++++++++++++++++++++
Jim HendersonLibrarian (Retired), McGill University
Consultant, Henderson & Associates
Canadian Virtual Health Library /
Bibliothèque virtuelle canadienne de la santé –Board Member (Treasurer) & CIHR Grant Co-Investigator
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Phone: 514-807-5863
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-----Original Message-----
From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Patricia Anderson
Sent: Saturday, September 22, 2012 12:25 PM
To: [log in to unmask]
Subject: Re: Complimentary Medicine - Absence of proof is not proof of absence
Hi, Margaret, I will try to track down the conversation. It was a couple months ago, and I'm having trouble remembering enough details to find which article it was. If I can find it, I'll share!
- Patricia
On Sat, Sep 22, 2012 at 7:14 AM, <[log in to unmask]> wrote:
> Dear Patricia and Kamlesh
>
> Very many thanks for your stimulating and detailed contributions. May
> I check, please, if when referring to what is or is not taught within
> particular programs, each of you are referring to teaching within the
> context of undergraduate medicine? My understanding is that in the
> UK, students require to take course of further study to become
> proficient in the theory of complementary and alternative medicine
> (CAM) and to be permitted to practise CAM within the NHS. Also,
> Patricia, I would be interested to receive reference details from you
> of the article you mention in your first paragraph.
>
> Many thanks
>
> Best wishes
>
> Margaret
>
> ________________________________
> From: Patricia Anderson <[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-profes
> sionals/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-bot
> anicals-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.htm
> l>
>
> Sage Publications: Journal of Evidence-Based Complementary &
> Alternative Medicine (JEBCAM) (formerly Complementary Health Practice
> Review)
>
> 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
> 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
>> 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
>>
>>
>
>
>
> --
> Patricia Anderson, [log in to unmask]
> Emerging Technologies Librarian
> University of Michigan
> http://www.lib.umich.edu/users/pfa
>
>
--
Patricia Anderson, [log in to unmask]
Emerging Technologies Librarian
University of Michigan
--
Patricia Anderson, [log in to unmask]
Emerging Technologies Librarian
University of Michigan
http://www.lib.umich.edu/users/pfa