NIH study proves Naturopathic Medicine works, or does it?
http://www.news-medical.net/?id=4613News-Medical.Net Study shows that naturopathicmedicine helps women experiencing jaw pains Posted By: News-Medical in Medical Study News Published: Wednesday, 8-Sep-2004
This study will likely not support the whole of Naturopathic medicine. Since study information is not yet available in peer review, I'll only go by this press release, which reads like a pro-Naturopathy tract. I note six observations about this report of an NIH study and add some comments.
1) "Naturopathic medicine is based upon a holistic philosophy, an approach to medical care that emphasizes the study of all aspects of a person's health, with an emphasis on finding the underlying cause of the patient’s condition rather than focusing solely on symptomatic treatment."
I would like to know what the University-based TMJ clinic would say if accused of "solely focusing on symptomatic treatment." I would be surprised if they do not use the very latest evidence and research behind the causes of TMJ - and I'm skeptical that it has much to do with toxins in the gut as inferred in the Naturopathic treatment arm protocol. My opinion: this report has statements of pro-Naturopathy propoganda that attempt to subversively legitimize the pseudo-scientific aspects of Naturopathic philosophy within the auspices of a scientific clinical study.
2) All patients had co-morbidness of menopause symptoms, CFS, or depression.
Selection bias. A TMJ clinic is not going to thoroughly evaluate and address interventions for these co-morbidities. Outcomes of the study will likely be influenced by symptomatic changes in the co-morbid conditions. For example, the treatment from the TMJ clinic is all about TMJ, the treatment in the Naturopathic arm is about the "whole" body. No subject will expect depression to get better by going to a TMJ clinic, so no one will report it. The Naturopathic arm is told treatment will improve everything, so such is reported by the subjects.
3) Each Naturopathic subject was seen by one of two Naturopathic physicians and allowed nine one-hour visits over a six-month period.
How did this compare with the other treatment arms? Did the TMJ clinic subjects get 9 one hour sessions with one of two physicians? If not, there is convincing evidence of unequal treatment arms that will introduce bias and not control for placebo effect.
4)In the Naturopathic arm, subjects were asked about their "...ability to detoxify harmful substances in the body..."
What is this line of questioning? Does it have something do with Naturopathy using the "most current advances in modern medicine" because I don't seem to recall similar questioning in any medical evaluation or differential diagnosis I am aware of. Please show me the clinical physiologic evidences where an inability "to detoxify harmful substances" has anything remotely to do with TMJ. This statement is an example of what's expressed in my opinon under #1 above.
5)The Naturopathic test subjects accepted changes in lifestyle as recommended by theNaturopathic practitioner.
Outcomes demonstrating the Naturopathic treatment arm as superior can not validate Naturopathic medicine as a whole as is apparently the argument of the article. What it can do is validate that doing more is better than doing less.
6)In the Naturopathic arm, patients reported “ 'transformational' changes. A number of patients came to believe that they had been “stuck” in their pain level and that they could not imagine that they could feel better. After the study, they reported they had become “unstuck” in their way of thinking."
Reporting bias. Could this outcome possibly be because the Naturopathic arm subjects are conditioned for this type of reporting as a result of the one-on-one counseling? Who would expect such reporting after treatment at a TMJ clinic?
Comments:
To the credit of the NIH and researchers, perhaps the visceral argument of the study is that mainstream medicine has to do better at addressing the spiritual, psychosocial, and psychological aspects that could be contributing to a health condition. How to do it, and what is appropriate by whom are the questions.
If you want to make an argument for the whole of Naturopathic medicine, I would like to see the study where the TMJ arm has all the lifestyle and other benign recommendations of the Naturopathic physician (or acceptable equivalents,) along with the one-on-one counseling. Then let the Naturopathic arm throw in the detox procedures and nutraceutical remedies. Even better would be to have another treatment arm use sham detox procedures and sham nutraceuticals.
It is disturbing that NCCAM seems to have created a study to exploit the obvious benefits of an expanded clinical approach in order to get society to swallow Naturopathic medicine whole, pseudo-science and all.
This study will likely not support the whole of Naturopathic medicine. Since study information is not yet available in peer review, I'll only go by this press release, which reads like a pro-Naturopathy tract. I note six observations about this report of an NIH study and add some comments.
1) "Naturopathic medicine is based upon a holistic philosophy, an approach to medical care that emphasizes the study of all aspects of a person's health, with an emphasis on finding the underlying cause of the patient’s condition rather than focusing solely on symptomatic treatment."
I would like to know what the University-based TMJ clinic would say if accused of "solely focusing on symptomatic treatment." I would be surprised if they do not use the very latest evidence and research behind the causes of TMJ - and I'm skeptical that it has much to do with toxins in the gut as inferred in the Naturopathic treatment arm protocol. My opinion: this report has statements of pro-Naturopathy propoganda that attempt to subversively legitimize the pseudo-scientific aspects of Naturopathic philosophy within the auspices of a scientific clinical study.
2) All patients had co-morbidness of menopause symptoms, CFS, or depression.
Selection bias. A TMJ clinic is not going to thoroughly evaluate and address interventions for these co-morbidities. Outcomes of the study will likely be influenced by symptomatic changes in the co-morbid conditions. For example, the treatment from the TMJ clinic is all about TMJ, the treatment in the Naturopathic arm is about the "whole" body. No subject will expect depression to get better by going to a TMJ clinic, so no one will report it. The Naturopathic arm is told treatment will improve everything, so such is reported by the subjects.
3) Each Naturopathic subject was seen by one of two Naturopathic physicians and allowed nine one-hour visits over a six-month period.
How did this compare with the other treatment arms? Did the TMJ clinic subjects get 9 one hour sessions with one of two physicians? If not, there is convincing evidence of unequal treatment arms that will introduce bias and not control for placebo effect.
4)In the Naturopathic arm, subjects were asked about their "...ability to detoxify harmful substances in the body..."
What is this line of questioning? Does it have something do with Naturopathy using the "most current advances in modern medicine" because I don't seem to recall similar questioning in any medical evaluation or differential diagnosis I am aware of. Please show me the clinical physiologic evidences where an inability "to detoxify harmful substances" has anything remotely to do with TMJ. This statement is an example of what's expressed in my opinon under #1 above.
5)The Naturopathic test subjects accepted changes in lifestyle as recommended by theNaturopathic practitioner.
Outcomes demonstrating the Naturopathic treatment arm as superior can not validate Naturopathic medicine as a whole as is apparently the argument of the article. What it can do is validate that doing more is better than doing less.
6)In the Naturopathic arm, patients reported “ 'transformational' changes. A number of patients came to believe that they had been “stuck” in their pain level and that they could not imagine that they could feel better. After the study, they reported they had become “unstuck” in their way of thinking."
Reporting bias. Could this outcome possibly be because the Naturopathic arm subjects are conditioned for this type of reporting as a result of the one-on-one counseling? Who would expect such reporting after treatment at a TMJ clinic?
Comments:
To the credit of the NIH and researchers, perhaps the visceral argument of the study is that mainstream medicine has to do better at addressing the spiritual, psychosocial, and psychological aspects that could be contributing to a health condition. How to do it, and what is appropriate by whom are the questions.
If you want to make an argument for the whole of Naturopathic medicine, I would like to see the study where the TMJ arm has all the lifestyle and other benign recommendations of the Naturopathic physician (or acceptable equivalents,) along with the one-on-one counseling. Then let the Naturopathic arm throw in the detox procedures and nutraceutical remedies. Even better would be to have another treatment arm use sham detox procedures and sham nutraceuticals.
It is disturbing that NCCAM seems to have created a study to exploit the obvious benefits of an expanded clinical approach in order to get society to swallow Naturopathic medicine whole, pseudo-science and all.
posted by nawledge at
7:32 PM
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