Probleme von Studiendesigns mit Randomisation, Verblindung und Placebogabe

Heusser, Peter

doi:10.1159/000021215

Cited by 13 publications

(12 citation statements)

References 82 publications

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“…Randomisation could ensure internally valid therapeutic studies. However, complementary medicine practitioners are often reluctant to use randomisation, due to the difficulty to ethically, practically and methodologically reconcile their holistic and individualised therapeutic approach with a random allocation to treatment [19]. This might lead to randomised studies on complementary treatments being conducted within conventional medicine institutions, thus hampering the external validity of the generated evidence.…”

Section: Discussionmentioning

confidence: 99%

Socio-Demographic and Medical Characteristics of Advanced Cancer Patients Using Conventional or Complementary Medicine

Pampallona¹,

Rohr²,

Wegberg³

et al. 2002

Oncol Res Treat

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Background: To provide prospective comparative data describing the profiles of two patient populations attending conventional or complementary medicine institutions. Patients and Methods: A registration study was set up in an oncology ward at the Institute for Medical Oncology (IMO) of the University Hospital in Bern, and at the Lukas Clinic (LC) for Anthroposophical Cancer Treatment in Arlesheim, Switzerland. The same eligibility criteria were applied to enrol into the study all newly referred or newly diagnosed patients with advanced cancer over a 2-year period. Their socio- demographic and clinical characteristics at presentation have been compared between the two institutions. Results: Patients at LC are primarily females, of higher educational level, and living in an urban environment. Patients at LC are also more frequently of poorer performance status but present with less comorbidity and a longer interval between diagnosis of metastatic disease and accrual into the study. Conclusion: This study suggests that the respective merits of these two schools of medicine can be assessed successfully only through a concrete research partnership based on rigorously controlled clinical trials.

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Section: Discussionmentioning

confidence: 99%

Socio-Demographic and Medical Characteristics of Advanced Cancer Patients Using Conventional or Complementary Medicine

Pampallona¹,

Rohr²,

Wegberg³

et al. 2002

Oncol Res Treat

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“…(5) Welche Untersuchungen zur Wirtschaftlichkeit liegen vor? Methodologische Besonderheiten: In der Komplementärmedi-zin und speziell in der AM wird seit Jahrzehnten ein intensiver Diskurs zur Methodologie klinischer Forschung geführt und auf den begrenzten Erkenntniswert und die limitierten Einsatzmöglichkeiten von randomisierten klinischen Studien (RCTs) sowie auf die Bedeutung einer umfassenden Evidenzgewinnung, speziell auch des wissenschaftlich geschulten ärzt- Kienle/Kiene/Albonico lichen Urteils, für medizinische Hilfeleistung, Erkenntnisgewinnung und Fortschritt verwiesen [3][4][5][6][7][8]. Diese Argumente sind auch in den Kriterien zur Beurteilung des Nutzens von komplementärmedizinischen Methoden («Handbuch zur Standardisierung der medizinischen und wirtschaftlichen Bewertung medizinischer Leistungen» des Schweizerischen Bundesamtes für Sozialversicherung, Ausgabe 2000) thematisiert.…”

Section: Hintergrund Und Fragestellungunclassified

Anthroposophische Medizin: Health Technology Assessment Bericht – Kurzfassung

Kienle

Kiene

Albonico³

2006

Forsch Komplementärmed

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The aim of this Health Technology Assessment Report was to analyse the current situation, efficacy, effectiveness, safety, utilization, and costs of Anthroposophic Medicine (AM) with special emphasis on everyday practice. Design: Systematic review. Material and Methods: Search of 20 databases, reference lists and expert consultations. Criteriabased analysis was performed to assess methodological quality and external validity of the studies. Results: AM is a complementary medical system that extends conventional medicine and provides specific pharmacological and non-pharmacological treatments. It covers all areas of medicine. 178 clinical trials on efficacy and effectiveness were identified: 17 RCTs, 21 prospective and 43 retrospective NRCTs, 50 prospective and 47 retrospective cohort studies/case-series without control groups. They investigated a wide range of AM-treatments in a variety of diseases, 90 × mistletoe in cancer. 170 trials had a positive result for AM. Methodological quality differed substantially; some studies showed major limitations, others were reasonably well conducted. Trials of better quality still showed a positive result. External validity was usually high. Side effects or other risks are rare. AMpatients are well educated, often female, aged 30-50 years, or children. The few economic investigations found less or equal costs in AM because of reduced hospital admissions and less prescriptions of medications. Conclusion: Trials of varying design and quality in a variety of diseases predominantly describe good clinical outcome for AM, little side effects, high satisfaction of patients and presumably slightly less costs. More research and more methodological expertise and infrastructure are desirable.

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“…Although every new biomedical intervention is being subjected to RCTs in order to prove its safety and efficacy, the quality of the studies and the relevance of their results are generally poor. The same is also true for the CAM interventions that are being scrutinized with the use of RCTs [36,37]. Thus, there is little a priori confidence in population benefit for most interventions.…”

Section: Discussionmentioning

confidence: 99%

Are Allopathic and Holistic Medicine Incommensurable?

Evangelatos

Eliadi

2016

Complement Med Res

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The shift from the Aristotelian to the Newtonian scientific paradigm gave birth to progresses in the natural, hard sciences and contributed to the emergence of modernity. Allopathic medicine gradually implemented those progresses, transforming itself into contemporary biomedicine. In the early 20th century, replacement of Newtonian physics by quantum mechanics and Einstein's theory of relativity resulted in a new paradigm shift in the natural, hard sciences. This shift gave birth to post-modern perceptions, which attempt to put those changes in context. Within this new context, holistic therapeutic approaches are considered more compatible with the new paradigm. Different paradigms in the natural, hard sciences are considered to be incommensurable (in the Kuhnian sense). This incommensurability is also transferred to the different societal contexts, the different «Weltanschauungen» that rely on different scientific paradigms. However, drawing on arguments that range from historical and philosophical to practical and sociological ones, we argue that, although based on different scientific paradigms, allopathic and holistic medicine are not incommensurable, but rather complementary. This may be related to the inherent attributes of medicine, a fact that reinforces the debate on its epistemological status.

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Probleme von Studiendesigns mit Randomisation, Verblindung und Placebogabe

Cited by 13 publications

References 82 publications

Socio-Demographic and Medical Characteristics of Advanced Cancer Patients Using Conventional or Complementary Medicine

Socio-Demographic and Medical Characteristics of Advanced Cancer Patients Using Conventional or Complementary Medicine

Anthroposophische Medizin: Health Technology Assessment Bericht – Kurzfassung

Are Allopathic and Holistic Medicine Incommensurable?

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