The Richard and Hinda Rosenthal Lectures -- 2001 Exploring Complementary and Alternative Medicine (2003) / Chapter Skim
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Discussion
Discussion
Pages 33-42
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From page 33... ...
Do you end up comparing an enthusiastic provider against a non-enthusiastic provider, or a set of enthusiastic providers doing the therapy in different ways? I understand how one performs an herbal trial, for example, but I am puzzled as to how, in a number of these therapies, you conduct a randomized control trial when you are looking at the effect of both the intervention and the enthusiasm of the provider.
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From page 34... ...
There are actually, I think, fairly good examples of sham placebo devices that can be used in patients who are naive to acupuncture, which are spring loaded and go through a tube. The person who is naive to real acupuncture, when punctured by this sham acupuncture needle, which is on a spring, feels the needle touching the skin but it never touches the skin; that is one level of control.
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From page 35... ...
PARTICIPANT: I was wondering, David, if you would comment on some policy that we have evolved at the Center for Substance Abuse Treatment, of the Substance Abuse and Mental Health Services Administration, that suggests the notion for the need for randomized clinical trial results, and may actually shed some light on your question of which should come first. That is, starting in about 1994 and 1995 with a program called the Rural, Remote, and Culturally Distinct Populations Program, populations were funded for comprehensive culturally appropriate substance abuse treatments.
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From page 36... ...
I think from a public health standpoint, you get an answer to your public health question. From an NIH scientific standpoint, you don't know what the actual cause and effect relationship of the individual components is.
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From page 37... ...
I didn't show two slides of an article published in the Archives of Internal Medicine this summer by Robert Blendon on his survey of adults' perceptions on dietary supplements. One of the more remarkable findings really points to a perception disconnect, if you will.
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From page 38... ...
You know, the notion that if you are a hammer, everything looks like a nail? If I were in a board room of Fortune 500 employers and their groups, I would say: you should invest in health service research to figure out which, if any, of these things should be in your benefit package or your cafeteria plan.
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From page 39... ...
I just toss that out as another method of acupuncture, which seems to complicate your life a little bit more. Also, I am intrigued by this whole idea of research, since acupuncture comes from a medical tradition that has a totally different paradigm than allopathic medicine and has a much longer tradition and history.
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From page 40... ...
I didn't see them on your list of integrative medicine stakeholders. There seems to be a lot of emphasis on allopathic medical schools and that also brings up the issue of doctors who are able to practice acupuncture by taking a 300-hour acupuncture course, as opposed to acupuncturists who have a much more substantial training.
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From page 41... ...
As a matter of fact, patients are a bit suspect if they are going to be covered by their managed care companies, and sometimes that has an effect on the results of their treatment. The second point I wanted to make was that very often with patients, especially if you look at stakeholders for patients covered by their insurance companies, they try to fit an eastern traditional medicine into western medicine.
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From page 42... ...
42 EXPLORING COMPLEMENTARY AND ALTERNATIVE MEDICINE business. Perhaps that would help FDA and the academic centers who formed these 11 centers to somehow get together with the entrepreneurial divisions of the universities and allocate funds to post an authoritative internet site.
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