The proper role of evidence in complementary/alternative medicine.
In this article we explore the role evidence ought to play in complementary and alternative medicine (CAM). First, we consider the claim that evidence in the form of randomized controlled trials (RCTs) cannot be obtained for CAMs. Second, we consider various claims to the effect that there are ways of obtaining evidence that do not make use of RCTs. We argue that there is no good reason why CAM should be exempted from the general requirement that treatments undergo evaluation by RCT. Third, we consider two implications for health care policy. First, many activities in conventional medicine have never been rigorously evaluated and are widely in use nonetheless. We argue that this fails to provide a reason for exempting CAM from a demand for evidence. Second, CAM use may be compared to a choice of lifestyle, and this has a significant impact on which requirements of evidence can reasonably be imposed.
Hansen
Kirsten
K
Department of Public Health, Section for Health Services Research, Oester Farimagsgade 5, Building 9, PO Box 2099, DK-1014 Copenhagen K, Denmark. khansen@pubhealth.ku.dk
Kappel
Klemens
K
D015984:Causality; D000529:Complementary Therapies / Q000941:ethics*; D019317:Evidence-Based Medicine / Q000941:ethics / Q000379:methods; D006291:Health Policy; D006801:Humans; D008019:Life Style; D009014:Morals; D010686:Philosophy, Medical; D016032:Randomized Controlled Trials as Topic / Q000941:ethics* / Q000379:methods*