Zone-Reflex: "Pseudoscience"???

söndag 23 januari 2011

"Pseudoscience"???

Josephine Briggs leading NIH effort to study alternative approaches

January 21, 2011. MemberCentral .
Science AAAS Member Josephine Briggs directs the NIH's program on complementary and alternative medicine. A physician trained in kidney neurology, she's working to bring scientific rigor to a field many consider "pseudoscience." CME/CEU Video Lecture with Dr. Briggs, NCCAM website .

What are they researching?
The placebo-effect A recent national survey of 679 physicians, funded in part by NCCAM, found that about half the physician respondents prescribed placebo treatments on a regular basis. Most (62%) said they think the practice is ethical. The surveyed physicians were internists and rheumatologists—specialties that commonly treat patients with debilitating chronic conditions. Mostly over-the-counter analgesics (41%) or vitamins (38%), and some used antibiotics (13%) or sedatives (13%) as placebos. Physicians most commonly described the treatments as medicine that is not typically used for the patient's condition but that might be beneficial.

A patient's visit to a provider—may produce its own placebo effects that can bring about significant symptom improvement. The part of the encounter that plays the greatest role in the placebo effect appears to be the physician-patient relationship.

Maybe it's all placebo? August 24, 2010.
A recent study in the New England Journal of Medicine (NEJM) showed a positive outcome for tai chi in the management of the troubling symptoms of fibromyalgia—a condition with which many patients struggle and for which conventional medicine has little to offer. That is why this study is so provocative—can a CAM modality really affect this condition?

Tai chi is one CAM practice that clearly illustrates the challenge of conducting clinical research in CAM. As an accompanying editorial in NEJM notes, it is a complex intervention involving multiple components: exercise, breathing, meditation, relaxation, and a practitioner. How do you control for all of these variables when designing a study? Some CAM proponents will say that it is the combination that makes the intervention work; many conventional researchers will say you must isolate the components to identify the active "ingredient." Critics will say it all just the placebo effect—you expect the intervention to work, and so it does.

This is a clear example of the challenges facing NCCAM and the researchers we fund—to develop methodologies to study complex CAM interventions upholding the rigorous standards of research and at the same time respecting the traditions and practices inherent in CAM. NCCAM recently held a workshop on research controls and methods to begin the dialogue that will lead to better studies in this area. Understanding the complexities of doing CAM research and developing the tools with which to study CAM more effectively is also a theme for our next strategic plan.

In the meantime, we are also interested in understanding and exploring the many components of the placebo effect: what role does expectation play? How important is the patient-provider interaction in health? What is the mind-body connection and how can it be harnessed to promote health and well being?