NCCAM comments on proving alternative medcines
Lots of tax dollars go toward the National Institute of Health's (NIH) office of Complimenteray and Alternative Medicine (NCCAM). Besides spending this money, they did get the following article published in JAMA-dr
Ethical Issues Concerning Research in Complementary and Alternative Medicine. Franklin G. Miller, Ezekiel J. Emanuel, Donald L. Rosenstein, and Stephen E. Straus JAMA 2004;291 599-604 (NIH including NCCAM affiliation)
The authors seem critical of current standards applied to the supplement industry: "..dietary supplements are not standardized, have high variability from one lot to another, may be adulterated with drugs or contaminated with heavy metals." And on another page: "The public interest served by demonstrating that drugs are safe and effective applies equally to herbal treatments, even though the current laws under which herbal products and other dietary supplements are regulated and marketed in the United States do not require proof of safety or efficacy."
In their discussion on placebo effect, the authors use "the fallacy of post hoc ergo propter hoc" to argue that ideally, a two arm study that control for placebo as well as a traditional treatment is needed to define comparative efficacy versus the CAM treatment. In reply to Dr. Kaptchuk's question: "Should a person with chronic neck pain who can not take diazapam because of unacceptable side effects be denied acupuncture that may have an 'enhanced placebo effect' because such an effect is 'bogus'?" an argument is presented that the answer could indeed be 'yes' if the placebo effect is determined not to be real, and can be attributed, for example, to a subject reporting to "please" the investigators or based on a belief that they are improved as a result of acupuncture treatment.
Overall, the authors argue that science based medicine should apply equally to CAM treatments. The impression I got was that such study is worthwhile because so much of CAM is prevalent in society today, there is scientific understanding to be gained, and society should know the proved benefit, or lack thereof, of individual CAM treatments.
Remember that this presentation from NCCAM is appearing in JAMA. I think many are waiting for anyone at NIH including NCCAM to be accountable for what has, and especially what has not, been accomplished thus far by NCCAM and all that govt. dough.
Ethical Issues Concerning Research in Complementary and Alternative Medicine. Franklin G. Miller, Ezekiel J. Emanuel, Donald L. Rosenstein, and Stephen E. Straus JAMA 2004;291 599-604 (NIH including NCCAM affiliation)
The authors seem critical of current standards applied to the supplement industry: "..dietary supplements are not standardized, have high variability from one lot to another, may be adulterated with drugs or contaminated with heavy metals." And on another page: "The public interest served by demonstrating that drugs are safe and effective applies equally to herbal treatments, even though the current laws under which herbal products and other dietary supplements are regulated and marketed in the United States do not require proof of safety or efficacy."
In their discussion on placebo effect, the authors use "the fallacy of post hoc ergo propter hoc" to argue that ideally, a two arm study that control for placebo as well as a traditional treatment is needed to define comparative efficacy versus the CAM treatment. In reply to Dr. Kaptchuk's question: "Should a person with chronic neck pain who can not take diazapam because of unacceptable side effects be denied acupuncture that may have an 'enhanced placebo effect' because such an effect is 'bogus'?" an argument is presented that the answer could indeed be 'yes' if the placebo effect is determined not to be real, and can be attributed, for example, to a subject reporting to "please" the investigators or based on a belief that they are improved as a result of acupuncture treatment.
Overall, the authors argue that science based medicine should apply equally to CAM treatments. The impression I got was that such study is worthwhile because so much of CAM is prevalent in society today, there is scientific understanding to be gained, and society should know the proved benefit, or lack thereof, of individual CAM treatments.
Remember that this presentation from NCCAM is appearing in JAMA. I think many are waiting for anyone at NIH including NCCAM to be accountable for what has, and especially what has not, been accomplished thus far by NCCAM and all that govt. dough.
posted by nawledge at
8:30 PM
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