Will duct tape cure my warts examining complementary and alternative medicine
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Will duct tape cure my warts? Examining Complementary and Alternative Medicine. National Network of Libraries of Medicine South Central Region. Agenda. Definitions History and Impact Usage and Therapies Evaluating Web Sites Avoiding Bad Science Recommended Websites

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Will duct tape cure my warts? Examining Complementary and Alternative Medicine

National Network of Libraries of Medicine

South Central Region


Agenda

  • Definitions

  • History and Impact

  • Usage and Therapies

  • Evaluating Web Sites

  • Avoiding Bad Science

  • Recommended Websites

  • Reviewing the Evidence


garlic pills

cabbage

alfalfa pills

e

castor oil

banana peel

iodine

toothpaste

How do you get rid of a wart?

potato

windex

nail polish

raw meat

silk thread

duct tape

witch hazel

aloe

dandelion juice

cigarette ashes

apple cider

quarters

c

orange peel


What is CAM?

  • Complementary and Alternative Medicine

  • Complementary: together with

    • aromatherapy to help with pain after surgery

  • Alternative: in place of

    • using garlic to lower blood pressure


CAM becomes “legit”

  • 1990

    • Wilk et al v. AMA

  • 1991

    • $2 million in funding to establish NIH Office of Alternative Medicine

  • 1994

    • Dietary Supplement Health and Education Act


CAM becomes “legit”

  • 1995

    • NIH Office of Dietary Supplements http://ods.od.nih.gov/

    • FDA declassifies Acupuncture needles as experimental product

  • 1996

    • NIH Consensus Conference on Acupuncture

  • 1997

    • First large trial of CAM therapy, St. John’s Wort for depression


CAM becomes “legit”

  • 1998

    • National Center for Complementary & Alternative Medicine (NCCAM) established http://nccam.nih.gov/

    • First full scale article in JAMA on herbal medicine

    • Office of Cancer Complementary and Alternative Medicine (OCCAM) established http://www.cancer.gov/cam/

  • 2001

    • CAM on PubMed (NCCAM and NLM)


Impact of CAM

  • CDC Report (2004)

    • 36% of adults used some form of CAM

    • 55% CAM + conventional treatments

    • 26% used CAM because a medical professional suggested it

    • $36-47 billion on CAM therapies in 1997

    • $5 billion on herbal remedies

  • JAMA (1998)

    • 12.1% of population use herbal medicine


Diseases and Conditions*

  • Back pain or problem

  • Head or chest cold

  • Neck pain or problem

  • Joint pain or stiffness

  • Anxiety/depression

  • Arthritis, gout, lupus or fibromyalgia

  • Stomach or intestinal illness

  • Severe headache or migraine

*Barnes PM,et al. Complementary and alternative medicine use among adults: United States 2002; CDC


Top 5 CAM Therapies*

  • Natural products, dietary supplements

  • Deep breathing exercises

  • Meditation

  • Chiropractic

  • Yoga

*Barnes PM,et al. Complementary and alternative medicine use among adults: United States 2002; CDC


Echinacea

Ginseng

Ginkgo biloba

Garlic

Glucosamine

St. John’s Wort

Peppermint

Fish oil/Omega 3

Ginger

Soy

Top 10 Supplements*

*Barnes PM,et al. Complementary and alternative medicine use among adults: United States 2002; CDC


Categorization of Therapies*

  • Whole Medical Systems

  • Biologically Based Practices

  • Energy Medicine

  • Manipulative and Body-Based Practices

  • Mind-Body Medicine

*National Center of Complementary and Alternative Therapy


Whole Medical Systems

  • Complete systems of theory and practice that evolved independently

  • Traditional systems of medicine that are practiced by individual cultures throughout the world

    • Includes traditional Chinese medicine, Ayurvedic medicine, homeopathy, naturopathy

*National Center of Complementary and Alternative Therapy


Biologically Based Practices

  • Includes: botanicals, animal-derived extracts, vitamins, minerals, fatty acids, amino acids, proteins, whole diets, and functional foods

    • Dietary supplements are a subset of biologically based practices

*National Center of Complementary and Alternative Therapy


Biologically Based - Supplements

  • What is a supplement?

  • Regulated by FDA http://www.fda.gov

    • no requirements for FDA testing

    • manufacturers responsible for ensuring product safety

    • label requirements

    • safety alerts: http://www.cfsan.fda.gov/~dms/ds-warn.html


Energy Medicine

  • Veritable - energy that can be measured

    • Includes sound, visible light, magnetism

  • Putative – energy that has yet to be measured

    • human beings are infused with a subtle form of energy

    • Includes qi (ki in Japanese); doshas; prana, homeopathic resonance

*National Center of Complementary and Alternative Therapy


Energy Medicine - Acupuncture

  • Few complications

  • Scientific evidence?

    • post chemotherapy management of nausea

    • pain relief

  • NIH Consensus Statement (1997)

    • http://consensus.nih.gov/1997/1997Acupuncture107html.htm


Manipulative and Body-Based

  • Structures and systems of the body, including the bones and joints, the soft tissues, and the circulatory and lymphatic systems

    • Includes chiropractic manipulation, massage therapy, reflexology, rolfing, Alexander technique,Feldenkrais method

*National Center of Complementary and Alternative Therapy


Mind-Body Medicine

  • Interactions among the brain, mind, body, and behavior

  • The ways in which emotional, mental, social, spiritual, and behavioral factors can directly affect health

    • Includes relaxation, hypnosis, visual imagery, meditation, yoga, biofeedback, tai chi, group support, and spirituality

*National Center of Complementary and Alternative Therapy


Other CAM Therapies

  • Aromatherapy

  • Colonic Irrigation

  • Therapeutic Touch

  • EDTA Chelation

  • Cupping

  • Primordial Sound Meditation


Avoiding Bad Science

  • The “One Product Does It All” claim

    http://www.emuoilcanada.com/

  • Personal Testimonials http://www.getslimslippers.com/

  • Quick Fixes/Cures

    http://www.cure-your-asthma.com

  • The “No Risk Money Back Guarantee” http://www.naturalhpvcure.com/

  • The “Natural” claim

    http://www.amtrueman.com/products.html


Evaluating Web Sites

  • Accuracy

  • Authority

  • Bias

  • Currency

  • Coverage


Examining the Research

  • Observational Studies

  • Clinical Trials/Studies

    • controlled

    • blind/double-blind

    • randomized

  • ClinicalTrials.gov

    • Government and private clinical studies involving humans

    • http://clinicaltrials.gov


Clinical Trials and CAM

  • Why are there so few CAM clinical trials?

    • Drug companies have to do studies to go on the market—supplement companies do not, so clinical trials sponsored by supplement companies are rare

    • Alternative treatments are often customized for a specific person. Clinical trials try to prove something works for most people.

    • Belief systems of some CAM practitioners do not agree with the idea of Western studies, so they do not participate

    • CAM has only recently become “legit” in the scientific community


Reviewing the Evidence

  • Evidence Based Medicine: “What evidence do we have to justify the treatment…”

  • National Center for Complementary and Alternative Medicine (NCCAM)

  • CAM on PubMed


Thank You!

National Network of Libraries of Medicine

South Central Region

800-338-7657


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