Alternative medicine

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Alternative medicine_table_infobox_0

Alternative medicineAlternative medicine_header_cell_0_0_0
ClaimsAlternative medicine_header_cell_0_1_0 Alternatives to reality-based medical treatmentsAlternative medicine_cell_0_1_1

Alternative medicine is any practice that aims to achieve the healing effects of medicine, but which lacks biological plausibility and is untested, untestable or proven ineffective. Alternative medicine_sentence_0

Complementary medicine (CM), complementary and alternative medicine (CAM), integrated medicine or integrative medicine (IM), and holistic medicine are among many rebrandings of the same phenomenon. Alternative medicine_sentence_1

Alternative therapies share in common that they reside outside medical science, and rely on pseudoscience. Alternative medicine_sentence_2

Traditional practices become "alternative" when used outside their original settings without proper scientific explanation and evidence. Alternative medicine_sentence_3

Frequently used derogatory terms for the alternative are new-age or pseudo, with little distinction from quackery. Alternative medicine_sentence_4

Some alternative practices are based on theories that contradict the science of how the human body works; others resort to the supernatural or superstitious to explain their effect. Alternative medicine_sentence_5

In others, the practice is plausibly effective but has too many side effects. Alternative medicine_sentence_6

Alternative medicine is distinct from scientific medicine, which employs the scientific method to test plausible therapies by way of responsible and ethical clinical trials, producing evidence of either effect or of no effect. Alternative medicine_sentence_7

Research into alternative therapies often fails to follow proper research protocols (such as placebo-controlled trials, blind experiments and calculation of prior probability), providing invalid results. Alternative medicine_sentence_8

Much of the perceived effect of an alternative practice arises from a belief that it will be effective (the placebo effect), or from the treated condition resolving on its own (the natural course of disease). Alternative medicine_sentence_9

This is further exacerbated by the tendency to turn to alternative therapies upon the failure of medicine, at which point the condition will be at its worst and most likely to spontaneously improve. Alternative medicine_sentence_10

In the absence of this bias, especially for diseases that are not expected to get better by themselves such as cancer or HIV infection, multiple studies have shown significantly worse outcomes if patients turn to alternative therapies. Alternative medicine_sentence_11

While this may be because these patients avoid effective treatment, some alternative therapies are actively harmful (e.g. cyanide poisoning from amygdalin, or the intentional ingestion of hydrogen peroxide) or actively interfere with effective treatments. Alternative medicine_sentence_12

The alternative sector is a highly profitable industry with a strong lobby, and faces far less regulation over the use and marketing of unproven treatments. Alternative medicine_sentence_13

Its marketing often advertises the treatments as being "natural" or "", in comparison to those offered by "big pharma". Alternative medicine_sentence_14

Billions of dollars have been spent studying alternative medicine, with few or no positive results. Alternative medicine_sentence_15

Some of the successful practices are only considered alternative under very specific definitions, such as those which include all physical activity under the umbrella of "alternative medicine". Alternative medicine_sentence_16

Definitions and terminology Alternative medicine_section_0

See also: Terminology of alternative medicine Alternative medicine_sentence_17

The terms alternative medicine, complementary medicine, integrative medicine, holistic medicine, natural medicine, unorthodox medicine, fringe medicine, unconventional medicine, and new age medicine are used interchangeably as having the same meaning, and are almost synonymous in most contexts. Alternative medicine_sentence_18

Terminology has shifted over time, reflecting the preferred branding of practitioners. Alternative medicine_sentence_19

For example, the United States National Institutes of Health department studying alternative medicine, currently named the National Center for Complementary and Integrative Health (NCCIH), was established as the Office of Alternative Medicine (OAM) and was renamed the National Center for Complementary and Alternative Medicine (NCCAM) before obtaining its current name. Alternative medicine_sentence_20

Therapies are often framed as "natural" or "holistic", implicitly and intentionally suggesting that conventional medicine is "artificial" and "narrow in scope". Alternative medicine_sentence_21

The meaning of the term "alternative" in the expression "alternative medicine", is not that it is an effective alternative to medical science, although some alternative medicine promoters may use the loose terminology to give the appearance of effectiveness. Alternative medicine_sentence_22

Loose terminology may also be used to suggest meaning that a dichotomy exists when it does not, e.g., the use of the expressions "Western medicine" and "Eastern medicine" to suggest that the difference is a cultural difference between the Asiatic east and the European west, rather than that the difference is between evidence-based medicine and treatments that do not work. Alternative medicine_sentence_23

Alternative medicine Alternative medicine_section_1

Alternative medicine is defined loosely as a set of products, practices, and theories that are believed or perceived by their users to have the healing effects of medicine, but whose effectiveness has not been established using scientific methods, or whose theory and practice is not part of biomedicine, or whose theories or practices are directly contradicted by scientific evidence or scientific principles used in biomedicine. Alternative medicine_sentence_24

"Biomedicine" or "medicine" is that part of medical science that applies principles of biology, physiology, molecular biology, biophysics, and other natural sciences to clinical practice, using scientific methods to establish the effectiveness of that practice. Alternative medicine_sentence_25

Unlike medicine, an alternative product or practice does not originate from using scientific methods, but may instead be based on hearsay, religion, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources. Alternative medicine_sentence_26

Some other definitions seek to specify alternative medicine in terms of its social and political marginality to mainstream healthcare. Alternative medicine_sentence_27

This can refer to the lack of support that alternative therapies receive from medical scientists regarding access to research funding, sympathetic coverage in the medical press, or inclusion in the standard medical curriculum. Alternative medicine_sentence_28

For example, a widely used definition devised by the US NCCIH calls it "a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine". Alternative medicine_sentence_29

However, these descriptive definitions are inadequate in the present-day when some conventional doctors offer alternative medical treatments and introductory courses or modules can be offered as part of standard undergraduate medical training; alternative medicine is taught in more than half of US medical schools and US health insurers are increasingly willing to provide reimbursement for alternative therapies. Alternative medicine_sentence_30

Complementary or integrative medicine Alternative medicine_section_2

Complementary medicine (CM) or integrative medicine (IM) is when alternative medicine is used together with functional medical treatment, in a belief that it improves the effect of treatments. Alternative medicine_sentence_31

For example, acupuncture (piercing the body with needles to influence the flow of a supernatural energy) might be believed to increase the effectiveness or "complement" science-based medicine when used at the same time. Alternative medicine_sentence_32

Instead, significant drug interactions caused by alternative therapies may make treatments less effective, notably in cancer therapy. Alternative medicine_sentence_33

Besides the usual issues with alternative medicine, integrative medicine has been described as an attempt to bring pseudoscience into academic science-based medicine, leading to the pejorative term "quackademic medicine". Alternative medicine_sentence_34

Due to its many names, the field has been criticized for intense rebranding of what are essentially the same practices. Alternative medicine_sentence_35

CAM is an abbreviation of the phrase complementary and alternative medicine. Alternative medicine_sentence_36

It has also been called sCAM or SCAM with the addition of "so-called" or "supplements". Alternative medicine_sentence_37

Other terms Alternative medicine_section_3

See also: Traditional medicine Alternative medicine_sentence_38

Traditional medicine refers to the pre-scientific practices of a certain culture, in contrast to what is typically practiced in cultures where medical science dominates. Alternative medicine_sentence_39

"Eastern medicine" typically refers to the traditional medicines of Asia where conventional bio-medicine penetrated much later. Alternative medicine_sentence_40

Holistic medicine is another rebranding of alternative medicine. Alternative medicine_sentence_41

In this case, the words balance and holism are often used alongside complementary or integrative, claiming to take into account a "whole" person, in contrast to the supposed reductionism of medicine. Alternative medicine_sentence_42

Challenges in defining alternative medicine Alternative medicine_section_4

Prominent members of the science and biomedical science community say that it is not meaningful to define an alternative medicine that is separate from a conventional medicine, because the expressions "conventional medicine", "alternative medicine", "complementary medicine", "integrative medicine", and "holistic medicine" do not refer to any medicine at all. Alternative medicine_sentence_43

Others say that alternative medicine cannot be precisely defined because of the diversity of theories and practices it includes, and because the boundaries between alternative and conventional medicine overlap, are porous, and change. Alternative medicine_sentence_44

Healthcare practices categorized as alternative may differ in their historical origin, theoretical basis, diagnostic technique, therapeutic practice and in their relationship to the medical mainstream. Alternative medicine_sentence_45

Under a definition of alternative medicine as "non-mainstream", treatments considered alternative in one location may be considered conventional in another. Alternative medicine_sentence_46

Critics say the expression is deceptive because it implies there is an effective alternative to science-based medicine, and that complementary is deceptive because it implies that the treatment increases the effectiveness of (complements) science-based medicine, while alternative medicines that have been tested nearly always have no measurable positive effect compared to a placebo. Alternative medicine_sentence_47

John Diamond wrote that "there is really no such thing as alternative medicine, just medicine that works and medicine that doesn't", a notion later echoed by Paul Offit: "the truth is there's no such thing as conventional or alternative or complementary or integrative or holistic medicine. Alternative medicine_sentence_48

There's only medicine that works and medicine that doesn't. Alternative medicine_sentence_49

And the best way to sort it out is by carefully evaluating scientific studies - not by visiting Internet chat rooms, reading magazine articles, or talking to friends." Alternative medicine_sentence_50

Comedian Tim Minchin has also taken to the issue in his viral animation short Storm: "By definition alternative medicine has either not been proved to work, or been proved not to work. Alternative medicine_sentence_51

Do you know what they call alternative medicine that's been proved to work? Alternative medicine_sentence_52

Medicine." Alternative medicine_sentence_53

Types Alternative medicine_section_5

See also: List of forms of alternative medicine Alternative medicine_sentence_54

Alternative medicine consists of a wide range of health care practices, products, and therapies. Alternative medicine_sentence_55

The shared feature is a claim to heal that is not based on the scientific method. Alternative medicine_sentence_56

Alternative medicine practices are diverse in their foundations and methodologies. Alternative medicine_sentence_57

Alternative medicine practices may be classified by their cultural origins or by the types of beliefs upon which they are based. Alternative medicine_sentence_58

Methods may incorporate or be based on traditional medicinal practices of a particular culture, folk knowledge, superstition, spiritual beliefs, belief in supernatural energies (antiscience), pseudoscience, errors in reasoning, propaganda, fraud, new or different concepts of health and disease, and any bases other than being proven by scientific methods. Alternative medicine_sentence_59

Different cultures may have their own unique traditional or belief based practices developed recently or over thousands of years, and specific practices or entire systems of practices. Alternative medicine_sentence_60

Unscientific belief systems Alternative medicine_section_6

Alternative medicine, such as using naturopathy or homeopathy in place of conventional medicine, is based on belief systems not grounded in science. Alternative medicine_sentence_61

Alternative medicine_table_general_1

Alternative medicine_header_cell_1_0_0 Proposed mechanismAlternative medicine_header_cell_1_0_1 IssuesAlternative medicine_header_cell_1_0_2
NaturopathyAlternative medicine_header_cell_1_1_0 Naturopathic medicine is based on a belief that the body heals itself using a supernatural vital energy that guides bodily processes.Alternative medicine_cell_1_1_1 In conflict with the paradigm of evidence-based medicine. Many naturopaths have opposed vaccination, and "scientific evidence does not support claims that naturopathic medicine can cure cancer or any other disease".Alternative medicine_cell_1_1_2
HomeopathyAlternative medicine_header_cell_1_2_0 A belief that a substance that causes the symptoms of a disease in healthy people cures similar symptoms in sick people.Alternative medicine_cell_1_2_1 Developed before knowledge of atoms and molecules, or of basic chemistry, which shows that repeated dilution as practiced in homeopathy produces only water, and that homeopathy is not scientifically valid.Alternative medicine_cell_1_2_2

Traditional ethnic systems Alternative medicine_section_7

Alternative medical systems may be based on traditional medicine practices, such as traditional Chinese medicine (TCM), Ayurveda in India, or practices of other cultures around the world. Alternative medicine_sentence_62

Some useful applications of traditional medicines have been researched and accepted within ordinary medicine, however the underlying belief systems are seldom scientific and are not accepted. Alternative medicine_sentence_63

Traditional medicine is considered alternative when it is used outside its home region; or when it is used together with or instead of known functional treatment; or when it can be reasonably expected that the patient or practitioner knows or should know that it will not work – such as knowing that the practice is based on superstition. Alternative medicine_sentence_64

Alternative medicine_table_general_2

Alternative medicine_header_cell_2_0_0 ClaimsAlternative medicine_header_cell_2_0_1 IssuesAlternative medicine_header_cell_2_0_2
Traditional Chinese medicineAlternative medicine_cell_2_1_0 Traditional practices and beliefs from China, together with modifications made by the Communist party make up TCM. Common practices include herbal medicine, acupuncture (insertion of needles in the body at specified points), massage (Tui na), exercise (qigong), and dietary therapy.Alternative medicine_cell_2_1_1 The practices are based on belief in a supernatural energy called qi, considerations of Chinese astrology and Chinese numerology, traditional use of herbs and other substances found in China, a belief that the tongue contains a map of the body that reflects changes in the body, and an incorrect model of the anatomy and physiology of internal organs.Alternative medicine_cell_2_1_2
AyurvedaAlternative medicine_cell_2_2_0 Traditional medicine of India. Ayurveda believes in the existence of three elemental substances, the doshas (called Vata, Pitta and Kapha), and states that a balance of the doshas results in health, while imbalance results in disease. Such disease-inducing imbalances can be adjusted and balanced using traditional herbs, minerals and heavy metals. Ayurveda stresses the use of plant-based medicines and treatments, with some animal products, and added minerals, including sulfur, arsenic, lead and copper sulfate.Alternative medicine_cell_2_2_1 Safety concerns have been raised about Ayurveda, with two U.S. studies finding about 20 percent of Ayurvedic Indian-manufactured patent medicines contained toxic levels of heavy metals such as lead, mercury and arsenic. A 2015 study of users in the United States also found elevated blood lead levels in 40 percent of those tested. Other concerns include the use of herbs containing toxic compounds and the lack of quality control in Ayurvedic facilities. Incidents of heavy metal poisoning have been attributed to the use of these compounds in the United States.Alternative medicine_cell_2_2_2

Supernatural energies Alternative medicine_section_8

Bases of belief may include belief in existence of supernatural energies undetected by the science of physics, as in biofields, or in belief in properties of the energies of physics that are inconsistent with the laws of physics, as in energy medicine. Alternative medicine_sentence_65

Alternative medicine_table_general_3

Alternative medicine_header_cell_3_0_0 ClaimsAlternative medicine_header_cell_3_0_1 IssuesAlternative medicine_header_cell_3_0_2
Biofield therapyAlternative medicine_cell_3_1_0 Intended to influence energy fields that, it is purported, surround and penetrate the body.Alternative medicine_cell_3_1_1 Advocates of scientific skepticism such as Carl Sagan have described the lack of empirical evidence to support the existence of the putative energy fields on which these therapies are predicated.Alternative medicine_cell_3_1_2
Bioelectromagnetic therapyAlternative medicine_cell_3_2_0 Use verifiable electromagnetic fields, such as pulsed fields, alternating-current, or direct-current fields in an unconventional manner.Alternative medicine_cell_3_2_1 Asserts that magnets can be used to defy the laws of physics to influence health and disease.Alternative medicine_cell_3_2_2
ChiropracticAlternative medicine_cell_3_3_0 Spinal manipulation aims to treat "vertebral subluxations" which are claimed to put pressure on nerves.Alternative medicine_cell_3_3_1 Chiropractic was developed in the belief that manipulating the spine affects the flow of a supernatural vital energy and thereby affects health and disease. Vertebral subluxation is a pseudoscientific concept and has not been proven to exist.Alternative medicine_cell_3_3_2
ReikiAlternative medicine_cell_3_4_0 Practitioners place their palms on the patient near Chakras that they believe are centers of supernatural energies in the belief that these supernatural energies can transfer from the practitioner's palms to heal the patient.Alternative medicine_cell_3_4_1 Lacks credible scientific evidence.Alternative medicine_cell_3_4_2

Herbal remedies and other substances Alternative medicine_section_9

See also: Phytotherapy Alternative medicine_sentence_66

Substance based practices use substances found in nature such as herbs, foods, non-vitamin supplements and megavitamins, animal and fungal products, and minerals, including use of these products in traditional medical practices that may also incorporate other methods. Alternative medicine_sentence_67

Examples include healing claims for nonvitamin supplements, fish oil, Omega-3 fatty acid, glucosamine, echinacea, flaxseed oil, and ginseng. Alternative medicine_sentence_68

Herbal medicine, or phytotherapy, includes not just the use of plant products, but may also include the use of animal and mineral products. Alternative medicine_sentence_69

It is among the most commercially successful branches of alternative medicine, and includes the tablets, powders and elixirs that are sold as "nutritional supplements". Alternative medicine_sentence_70

Only a very small percentage of these have been shown to have any efficacy, and there is little regulation as to standards and safety of their contents. Alternative medicine_sentence_71

This may include use of known toxic substances, such as use of the poison lead in traditional Chinese medicine. Alternative medicine_sentence_72

Religion, faith healing, and prayer Alternative medicine_section_10

See also: Shamanism Alternative medicine_sentence_73

Alternative medicine_table_general_4

Alternative medicine_header_cell_4_0_0 ClaimsAlternative medicine_header_cell_4_0_1 IssuesAlternative medicine_header_cell_4_0_2
Christian faith healingAlternative medicine_cell_4_1_0 There is a divine or spiritual intervention in healing.Alternative medicine_cell_4_1_1 Lack of evidence for effectiveness. Unwanted outcomes, such as death and disability, "have occurred when faith healing was elected instead of medical care for serious injuries or illnesses". A 2001 double-blind study of 799 discharged coronary surgery patients found that "intercessory prayer had no significant effect on medical outcomes after hospitalization in a coronary care unit."Alternative medicine_cell_4_1_2

NCCIH classification Alternative medicine_section_11

A US agency, National Center on Complementary and Integrative Health (NCCIH), has created a classification system for branches of complementary and alternative medicine that divides them into five major groups. Alternative medicine_sentence_74

These groups have some overlap, and distinguish two types of energy medicine: veritable which involves scientifically observable energy (including magnet therapy, colorpuncture and light therapy) and putative, which invokes physically undetectable or unverifiable energy. Alternative medicine_sentence_75

None of these energies have any evidence to support that they effect the body in any positive or health promoting way. Alternative medicine_sentence_76

Alternative medicine_ordered_list_0

  1. Whole medical systems: Cut across more than one of the other groups; examples include traditional Chinese medicine, naturopathy, homeopathy, and ayurveda.Alternative medicine_item_0_0
  2. Mind-body interventions: Explore the interconnection between the mind, body, and spirit, under the premise that they affect "bodily functions and symptoms". A connection between mind and body is conventional medical fact, and this classification does not include therapies with proven function such as cognitive behavioral therapy.Alternative medicine_item_0_1
  3. "Biology"-based practices: Use substances found in nature such as herbs, foods, vitamins, and other natural substances. (Note that as used here, "biology" does not refer to the science of biology, but is a usage newly coined by NCCIH in the primary source used for this article. "Biology-based" as coined by NCCIH may refer to chemicals from a nonbiological source, such as use of the poison lead in traditional Chinese medicine, and to other nonbiological substances.)Alternative medicine_item_0_2
  4. Manipulative and body-based practices: feature manipulation or movement of body parts, such as is done in bodywork, chiropractic, and osteopathic manipulation.Alternative medicine_item_0_3
  5. Energy medicine: is a domain that deals with putative and verifiable energy fields:Alternative medicine_item_0_4
    • Biofield therapies are intended to influence energy fields that are purported to surround and penetrate the body. The existence of such energy fields have been disproven.Alternative medicine_item_0_5
    • Bioelectromagnetic-based therapies use verifiable electromagnetic fields, such as pulsed fields, alternating-current, or direct-current fields in a non-scientific manner.Alternative medicine_item_0_6

History Alternative medicine_section_12

Main article: History of alternative medicine Alternative medicine_sentence_77

The history of alternative medicine may refer to the history of a group of diverse medical practices that were collectively promoted as "alternative medicine" beginning in the 1970s, to the collection of individual histories of members of that group, or to the history of western medical practices that were labeled "irregular practices" by the western medical establishment. Alternative medicine_sentence_78

It includes the histories of complementary medicine and of integrative medicine. Alternative medicine_sentence_79

Before the 1970s, western practitioners that were not part of the increasingly science-based medical establishment were referred to "irregular practitioners", and were dismissed by the medical establishment as unscientific and as practicing quackery. Alternative medicine_sentence_80

Until the 1970s, irregular practice became increasingly marginalized as quackery and fraud, as western medicine increasingly incorporated scientific methods and discoveries, and had a corresponding increase in success of its treatments. Alternative medicine_sentence_81

In the 1970s, irregular practices were grouped with traditional practices of nonwestern cultures and with other unproven or disproven practices that were not part of biomedicine, with the entire group collectively marketed and promoted under the single expression "alternative medicine". Alternative medicine_sentence_82

Use of alternative medicine in the west began to rise following the counterculture movement of the 1960s, as part of the rising new age movement of the 1970s. Alternative medicine_sentence_83

This was due to misleading mass marketing of "alternative medicine" being an effective "alternative" to biomedicine, changing social attitudes about not using chemicals and challenging the establishment and authority of any kind, sensitivity to giving equal measure to beliefs and practices of other cultures (cultural relativism), and growing frustration and desperation by patients about limitations and side effects of science-based medicine. Alternative medicine_sentence_84

At the same time, in 1975, the American Medical Association, which played the central role in fighting quackery in the United States, abolished its quackery committee and closed down its Department of Investigation. Alternative medicine_sentence_85

By the early to mid 1970s the expression "alternative medicine" came into widespread use, and the expression became mass marketed as a collection of "natural" and effective treatment "alternatives" to science-based biomedicine. Alternative medicine_sentence_86

By 1983, mass marketing of "alternative medicine" was so pervasive that the British Medical Journal (BMJ) pointed to "an apparently endless stream of books, articles, and radio and television programmes urge on the public the virtues of (alternative medicine) treatments ranging from meditation to drilling a hole in the skull to let in more oxygen". Alternative medicine_sentence_87

An analysis of trends in the criticism of complementary and alternative medicine (CAM) in five prestigious American medical journals during the period of reorganization within medicine (1965–1999) was reported as showing that the medical profession had responded to the growth of CAM in three phases, and that in each phase, changes in the medical marketplace had influenced the type of response in the journals. Alternative medicine_sentence_88

Changes included relaxed medical licensing, the development of managed care, rising consumerism, and the establishment of the USA Office of Alternative Medicine (later National Center for Complementary and Alternative Medicine, currently National Center for Complementary and Integrative Health). Alternative medicine_sentence_89

Medical education Alternative medicine_section_13

Mainly as a result of reforms following the Flexner Report of 1910 medical education in established medical schools in the US has generally not included alternative medicine as a teaching topic. Alternative medicine_sentence_90

Typically, their teaching is based on current practice and scientific knowledge about: anatomy, physiology, histology, embryology, neuroanatomy, pathology, pharmacology, microbiology and immunology. Alternative medicine_sentence_91

Medical schools' teaching includes such topics as doctor-patient communication, ethics, the art of medicine, and engaging in complex clinical reasoning (medical decision-making). Alternative medicine_sentence_92

Writing in 2002, Snyderman and Weil remarked that by the early twentieth century the Flexner model had helped to create the 20th-century academic health center, in which education, research, and practice were inseparable. Alternative medicine_sentence_93

While this had much improved medical practice by defining with increasing certainty the pathophysiological basis of disease, a single-minded focus on the pathophysiological had diverted much of mainstream American medicine from clinical conditions that were not well understood in mechanistic terms, and were not effectively treated by conventional therapies. Alternative medicine_sentence_94

By 2001 some form of CAM training was being offered by at least 75 out of 125 medical schools in the US. Alternative medicine_sentence_95

Exceptionally, the School of Medicine of the University of Maryland, Baltimore includes a research institute for integrative medicine (a member entity of the Cochrane Collaboration). Alternative medicine_sentence_96

Medical schools are responsible for conferring medical degrees, but a physician typically may not legally practice medicine until licensed by the local government authority. Alternative medicine_sentence_97

Licensed physicians in the US who have attended one of the established medical schools there have usually graduated Doctor of Medicine (MD). Alternative medicine_sentence_98

All states require that applicants for MD licensure be graduates of an approved medical school and complete the United States Medical Licensing Exam (USMLE). Alternative medicine_sentence_99

Efficacy Alternative medicine_section_14

There is a general scientific consensus that alternative therapies lack the requisite scientific validation, and their effectiveness is either unproved or disproved. Alternative medicine_sentence_100

Many of the claims regarding the efficacy of alternative medicines are controversial, since research on them is frequently of low quality and methodologically flawed. Alternative medicine_sentence_101

Selective publication bias, marked differences in product quality and standardisation, and some companies making unsubstantiated claims call into question the claims of efficacy of isolated examples where there is evidence for alternative therapies. Alternative medicine_sentence_102

The Scientific Review of Alternative Medicine points to confusions in the general population – a person may attribute symptomatic relief to an otherwise-ineffective therapy just because they are taking something (the placebo effect); the natural recovery from or the cyclical nature of an illness (the regression fallacy) gets misattributed to an alternative medicine being taken; a person not diagnosed with science-based medicine may never originally have had a true illness diagnosed as an alternative disease category. Alternative medicine_sentence_103

Edzard Ernst characterized the evidence for many alternative techniques as weak, nonexistent, or negative and in 2011 published his estimate that about 7.4% were based on "sound evidence", although he believes that may be an overestimate. Alternative medicine_sentence_104

Ernst has concluded that 95% of the alternative therapies he and his team studied, including acupuncture, herbal medicine, homeopathy, and reflexology, are "statistically indistinguishable from placebo treatments", but he also believes there is something that conventional doctors can usefully learn from the chiropractors and homeopath: this is the therapeutic value of the placebo effect, one of the strangest phenomena in medicine. Alternative medicine_sentence_105

In 2003, a project funded by the CDC identified 208 condition-treatment pairs, of which 58% had been studied by at least one randomized controlled trial (RCT), and 23% had been assessed with a meta-analysis. Alternative medicine_sentence_106

According to a 2005 book by a US Institute of Medicine panel, the number of RCTs focused on CAM has risen dramatically. Alternative medicine_sentence_107

As of 2005, the Cochrane Library had 145 CAM-related Cochrane systematic reviews and 340 non-Cochrane systematic reviews. Alternative medicine_sentence_108

An analysis of the conclusions of only the 145 Cochrane reviews was done by two readers. Alternative medicine_sentence_109

In 83% of the cases, the readers agreed. Alternative medicine_sentence_110

In the 17% in which they disagreed, a third reader agreed with one of the initial readers to set a rating. Alternative medicine_sentence_111

These studies found that, for CAM, 38.4% concluded positive effect or possibly positive (12.4%), 4.8% concluded no effect, 0.7% concluded harmful effect, and 56.6% concluded insufficient evidence. Alternative medicine_sentence_112

An assessment of conventional treatments found that 41.3% concluded positive or possibly positive effect, 20% concluded no effect, 8.1% concluded net harmful effects, and 21.3% concluded insufficient evidence. Alternative medicine_sentence_113

However, the CAM review used the more developed 2004 Cochrane database, while the conventional review used the initial 1998 Cochrane database. Alternative medicine_sentence_114

Alternative therapies do not "complement" (improve the effect of, or mitigate the side effects of) functional medical treatment. Alternative medicine_sentence_115

Significant drug interactions caused by alternative therapies may instead negatively impact functional treatment by making prescription drugs less effective, such as interference by herbal preparations with warfarin. Alternative medicine_sentence_116

In the same way as for conventional therapies, drugs, and interventions, it can be difficult to test the efficacy of alternative medicine in clinical trials. Alternative medicine_sentence_117

In instances where an established, effective, treatment for a condition is already available, the Helsinki Declaration states that withholding such treatment is unethical in most circumstances. Alternative medicine_sentence_118

Use of standard-of-care treatment in addition to an alternative technique being tested may produce confounded or difficult-to-interpret results. Alternative medicine_sentence_119

Cancer researcher Andrew J. Vickers has stated: Alternative medicine_sentence_120

Perceived mechanism of effect Alternative medicine_section_15

Anything classified as alternative medicine by definition does not have a healing or medical effect. Alternative medicine_sentence_121

However, there are different mechanisms through which it can be perceived to "work". Alternative medicine_sentence_122

The common denominator of these mechanisms is that effects are miss-attributed to the alternative treatment. Alternative medicine_sentence_123

Placebo effect Alternative medicine_section_16

A placebo is a treatment with no intended therapeutic value. Alternative medicine_sentence_124

An example of a placebo is an inert pill, but it can include more dramatic interventions like sham surgery. Alternative medicine_sentence_125

The placebo effect is the concept that patients will perceive an improvement after being treated with an inert treatment. Alternative medicine_sentence_126

The opposite of the placebo effect is the nocebo effect, when patients who expect a treatment to be harmful will perceive harmful effects after taking it. Alternative medicine_sentence_127

Placebos do not have a physical effect on diseases or improve overall outcomes, but patients may report improvements in subjective outcomes such as pain and nausea. Alternative medicine_sentence_128

A 1955 study suggested that a substantial part of a medicine's impact was due to the placebo effect. Alternative medicine_sentence_129

However, reassessments found the study to have flawed methodology. Alternative medicine_sentence_130

This and other modern reviews suggest that other factors like natural recovery and reporting bias should also be considered. Alternative medicine_sentence_131

All of these are reasons why alternative therapies may be credited for improving a patient's condition even though the objective effect is non-existent, or even harmful. Alternative medicine_sentence_132

David Gorski argues that alternative treatments should be treated as a placebo, rather than as medicine. Alternative medicine_sentence_133

Almost none have performed significantly better than a placebo in clinical trials. Alternative medicine_sentence_134

Furthermore, distrust of conventional medicine may lead to patients experiencing the nocebo effect when taking effective medication. Alternative medicine_sentence_135

Regression to the mean Alternative medicine_section_17

A patient who receives an inert treatment may report improvements afterwards that it did not cause. Alternative medicine_sentence_136

Assuming it was the cause without evidence is an example of the regression fallacy. Alternative medicine_sentence_137

This may be due to a natural recovery from the illness, or a fluctuation in the symptoms of a long-term condition. Alternative medicine_sentence_138

The concept of regression toward the mean implies that an extreme result is more likely to be followed by a less extreme result. Alternative medicine_sentence_139

Other factors Alternative medicine_section_18

There are also reasons why a placebo treatment group may outperform a "no-treatment" group in a test which are not related to a patient's experience. Alternative medicine_sentence_140

These include patients reporting more favourable results than they really felt due to politeness or "experimental subordination", observer bias, and misleading wording of questions. Alternative medicine_sentence_141

In their 2010 systematic review of studies into placebos, Asbjørn Hróbjartsson and Peter C. Gøtzsche write that "even if there were no true effect of placebo, one would expect to record differences between placebo and no-treatment groups due to bias associated with lack of blinding." Alternative medicine_sentence_142

Alternative therapies may also be credited for perceived improvement through decreased use or effect of medical treatment, and therefore either decreased side effects or nocebo effects towards standard treatment. Alternative medicine_sentence_143

Use and regulation Alternative medicine_section_19

Appeal Alternative medicine_section_20

Practitioners of complementary medicine usually discuss and advise patients as to available alternative therapies. Alternative medicine_sentence_144

Patients often express interest in mind-body complementary therapies because they offer a non-drug approach to treating some health conditions. Alternative medicine_sentence_145

In addition to the social-cultural underpinnings of the popularity of alternative medicine, there are several psychological issues that are critical to its growth, notably psychological effects, such as the will to believe, cognitive biases that help maintain self-esteem and promote harmonious social functioning, and the post hoc, ergo propter hoc fallacy. Alternative medicine_sentence_146

Marketing Alternative medicine_section_21

Alternative medicine is a highly profitable industry, with a strong lobby. Alternative medicine_sentence_147

This fact is often overlooked by media or intentionally kept hidden, with alternative practice being portrayed positively when compared to "big pharma". Alternative medicine_sentence_148

The popularity of complementary & alternative medicine (CAM) may be related to other factors that Edzard Ernst mentioned in an interview in The Independent: Alternative medicine_sentence_149

Paul Offit proposed that "alternative medicine becomes quackery" in four ways: by recommending against conventional therapies that are helpful, promoting potentially harmful therapies without adequate warning, draining patients' bank accounts, or by promoting "magical thinking." Alternative medicine_sentence_150

Promoting alternative medicine has been called dangerous and unethical. Alternative medicine_sentence_151

Social factors Alternative medicine_section_22

Authors have speculated on the socio-cultural and psychological reasons for the appeal of alternative medicines among the minority using them in lieu of conventional medicine. Alternative medicine_sentence_152

There are several socio-cultural reasons for the interest in these treatments centered on the low level of scientific literacy among the public at large and a concomitant increase in antiscientific attitudes and new age mysticism. Alternative medicine_sentence_153

Related to this are vigorous marketing of extravagant claims by the alternative medical community combined with inadequate media scrutiny and attacks on critics. Alternative medicine_sentence_154

Alternative medicine is criticized for taking advantage of the least fortunate members of society. Alternative medicine_sentence_155

There is also an increase in conspiracy theories toward conventional medicine and pharmaceutical companies, mistrust of traditional authority figures, such as the physician, and a dislike of the current delivery methods of scientific biomedicine, all of which have led patients to seek out alternative medicine to treat a variety of ailments. Alternative medicine_sentence_156

Many patients lack access to contemporary medicine, due to a lack of private or public health insurance, which leads them to seek out lower-cost alternative medicine. Alternative medicine_sentence_157

Medical doctors are also aggressively marketing alternative medicine to profit from this market. Alternative medicine_sentence_158

Patients can be averse to the painful, unpleasant, and sometimes-dangerous side effects of biomedical treatments. Alternative medicine_sentence_159

Treatments for severe diseases such as cancer and HIV infection have well-known, significant side-effects. Alternative medicine_sentence_160

Even low-risk medications such as antibiotics can have potential to cause life-threatening anaphylactic reactions in a very few individuals. Alternative medicine_sentence_161

Many medications may cause minor but bothersome symptoms such as cough or upset stomach. Alternative medicine_sentence_162

In all of these cases, patients may be seeking out alternative therapies to avoid the adverse effects of conventional treatments. Alternative medicine_sentence_163

Prevalence of use Alternative medicine_section_23

According to recent research, the increasing popularity of the CAM needs to be explained by moral convictions or lifestyle choices rather than by economic reasoning. Alternative medicine_sentence_164

In developing nations, access to essential medicines is severely restricted by lack of resources and poverty. Alternative medicine_sentence_165

Traditional remedies, often closely resembling or forming the basis for alternative remedies, may comprise primary healthcare or be integrated into the healthcare system. Alternative medicine_sentence_166

In Africa, traditional medicine is used for 80% of primary healthcare, and in developing nations as a whole over one-third of the population lack access to essential medicines. Alternative medicine_sentence_167

Some have proposed adopting a prize system to reward medical research. Alternative medicine_sentence_168

However, public funding for research exists. Alternative medicine_sentence_169

In the US increasing the funding for research on alternative medicine is the purpose of the US National Center for Complementary and Alternative Medicine (NCCAM). Alternative medicine_sentence_170

NCCAM has spent more than US$2.5 billion on such research since 1992 and this research has not demonstrated the efficacy of alternative therapies. Alternative medicine_sentence_171

The NCCAM's sister organization in the NIC Office of Cancer Complementary and Alternative Medicine gives grants of around $105 million every year. Alternative medicine_sentence_172

Testing alternative medicine that has no scientific basis has been called a waste of scarce research resources. Alternative medicine_sentence_173

That alternative medicine has been on the rise "in countries where Western science and scientific method generally are accepted as the major foundations for healthcare, and 'evidence-based' practice is the dominant paradigm" was described as an "enigma" in the Medical Journal of Australia. Alternative medicine_sentence_174

In the US Alternative medicine_section_24

In the United States, the 1974 Child Abuse Prevention and Treatment Act (CAPTA) required that for states to receive federal money, they had to grant religious exemptions to child neglect and abuse laws regarding religion-based healing practices. Alternative medicine_sentence_175

Thirty-one states have child-abuse religious exemptions. Alternative medicine_sentence_176

The use of alternative medicine in the US has increased, with a 50 percent increase in expenditures and a 25 percent increase in the use of alternative therapies between 1990 and 1997 in America. Alternative medicine_sentence_177

Americans spend many billions on the therapies annually. Alternative medicine_sentence_178

Most Americans used CAM to treat and/or prevent musculoskeletal conditions or other conditions associated with chronic or recurring pain. Alternative medicine_sentence_179

In America, women were more likely than men to use CAM, with the biggest difference in use of mind-body therapies including prayer specifically for health reasons". Alternative medicine_sentence_180

In 2008, more than 37% of American hospitals offered alternative therapies, up from 27 percent in 2005, and 25% in 2004. Alternative medicine_sentence_181

More than 70% of the hospitals offering CAM were in urban areas. Alternative medicine_sentence_182

A survey of Americans found that 88 percent thought that "there are some good ways of treating sickness that medical science does not recognize". Alternative medicine_sentence_183

Use of magnets was the most common tool in energy medicine in America, and among users of it, 58 percent described it as at least "sort of scientific", when it is not at all scientific. Alternative medicine_sentence_184

In 2002, at least 60 percent of US medical schools have at least some class time spent teaching alternative therapies. Alternative medicine_sentence_185

"Therapeutic touch" was taught at more than 100 colleges and universities in 75 countries before the practice was debunked by a nine-year-old child for a school science project. Alternative medicine_sentence_186

Prevalence of use of specific therapies Alternative medicine_section_25

The most common CAM therapies used in the US in 2002 were prayer (45%), herbalism (19%), breathing meditation (12%), meditation (8%), chiropractic medicine (8%), yoga (5–6%), body work (5%), diet-based therapy (4%), progressive relaxation (3%), mega-vitamin therapy (3%) and Visualization (2%) Alternative medicine_sentence_187

In Britain, the most often used alternative therapies were Alexander technique, Aromatherapy, Bach and other flower remedies, Body work therapies including massage, Counseling stress therapies, hypnotherapy, Meditation, Reflexology, Shiatsu, Ayurvedic medicine, Nutritional medicine, and Yoga. Alternative medicine_sentence_188

Ayurvedic medicine remedies are mainly plant based with some use of animal materials. Alternative medicine_sentence_189

Safety concerns include the use of herbs containing toxic compounds and the lack of quality control in Ayurvedic facilities. Alternative medicine_sentence_190

According to the National Health Service (England), the most commonly used complementary and alternative medicines (CAM) supported by the NHS in the UK are: acupuncture, aromatherapy, chiropractic, homeopathy, massage, osteopathy and clinical hypnotherapy. Alternative medicine_sentence_191

In palliative care Alternative medicine_section_26

Complementary therapies are often used in palliative care or by practitioners attempting to manage chronic pain in patients. Alternative medicine_sentence_192

Integrative medicine is considered more acceptable in the interdisciplinary approach used in palliative care than in other areas of medicine. Alternative medicine_sentence_193

"From its early experiences of care for the dying, palliative care took for granted the necessity of placing patient values and lifestyle habits at the core of any design and delivery of quality care at the end of life. Alternative medicine_sentence_194

If the patient desired complementary therapies, and as long as such treatments provided additional support and did not endanger the patient, they were considered acceptable." Alternative medicine_sentence_195

The non-pharmacologic interventions of complementary medicine can employ mind-body interventions designed to "reduce pain and concomitant mood disturbance and increase quality of life." Alternative medicine_sentence_196

Regulation Alternative medicine_section_27

Further information: Regulation of alternative medicine and Regulation and prevalence of homeopathy Alternative medicine_sentence_197

The alternative medicine lobby has successfully pushed for alternative therapies to be subject to far less regulation than conventional medicine. Alternative medicine_sentence_198

Some professions of complementary/traditional/alternative medicine, such as chiropractic, have achieved full regulation in North America and other parts of the world and are regulated in a manner similar to that governing science-based medicine. Alternative medicine_sentence_199

In contrast, other approaches may be partially recognized and others have no regulation at all. Alternative medicine_sentence_200

In some cases, promotion of alternative therapies is allowed when there is demonstrably no effect, only a tradition of use. Alternative medicine_sentence_201

Despite laws making it illegal to market or promote alternative therapies for use in cancer treatment, many practitioners promote them. Alternative medicine_sentence_202

Regulation and licensing of alternative medicine ranges widely from country to country, and state to state. Alternative medicine_sentence_203

In Austria and Germany complementary and alternative medicine is mainly in the hands of doctors with MDs, and half or more of the American alternative practitioners are licensed MDs. Alternative medicine_sentence_204

In Germany herbs are tightly regulated: half are prescribed by doctors and covered by health insurance. Alternative medicine_sentence_205

Government bodies in the US and elsewhere have published information or guidance about alternative medicine. Alternative medicine_sentence_206

The U.S. Alternative medicine_sentence_207 Food and Drug Administration (FDA), has issued online warnings for consumers about medication health fraud. Alternative medicine_sentence_208

This includes a section on Alternative Medicine Fraud, such as a warning that Ayurvedic products generally have not been approved by the FDA before marketing. Alternative medicine_sentence_209

Risks and problems Alternative medicine_section_28

Negative outcomes Alternative medicine_section_29

See also: List of herbs with known adverse effects Alternative medicine_sentence_210

Adequacy of regulation and CAM safety Alternative medicine_section_30

Many of the claims regarding the safety and efficacy of alternative medicine are controversial. Alternative medicine_sentence_211

Some alternative therapies have been associated with unexpected side effects, which can be fatal. Alternative medicine_sentence_212

A commonly voiced concerns about complementary alternative medicine (CAM) is the way it's regulated. Alternative medicine_sentence_213

There have been significant developments in how CAMs should be assessed prior to re-sale in the United Kingdom and the European Union (EU) in the last 2 years. Alternative medicine_sentence_214

Despite this, it has been suggested that current regulatory bodies have been ineffective in preventing deception of patients as many companies have re-labelled their drugs to avoid the new laws. Alternative medicine_sentence_215

There is no general consensus about how to balance consumer protection (from false claims, toxicity, and advertising) with freedom to choose remedies. Alternative medicine_sentence_216

Advocates of CAM suggest that regulation of the industry will adversely affect patients looking for alternative ways to manage their symptoms, even if many of the benefits may represent the placebo affect. Alternative medicine_sentence_217

Some contend that alternative medicines should not require any more regulation than over-the-counter medicines that can also be toxic in overdose (such as paracetamol). Alternative medicine_sentence_218

Interactions with conventional pharmaceuticals Alternative medicine_section_31

Forms of alternative medicine that are biologically active can be dangerous even when used in conjunction with conventional medicine. Alternative medicine_sentence_219

Examples include immuno-augmentation therapy, shark cartilage, bioresonance therapy, oxygen and ozone therapies, and insulin potentiation therapy. Alternative medicine_sentence_220

Some herbal remedies can cause dangerous interactions with chemotherapy drugs, radiation therapy, or anesthetics during surgery, among other problems. Alternative medicine_sentence_221

An example of these dangers was reported by Associate Professor Alastair MacLennan of Adelaide University, Australia regarding a patient who almost bled to death on the operating table after neglecting to mention that she had been taking "natural" potions to "build up her strength" before the operation, including a powerful anticoagulant that nearly caused her death. Alternative medicine_sentence_222

To ABC Online, MacLennan also gives another possible mechanism: Alternative medicine_sentence_223

Side-effects Alternative medicine_section_32

Conventional treatments are subjected to testing for undesired side-effects, whereas alternative therapies, in general, are not subjected to such testing at all. Alternative medicine_sentence_224

Any treatment – whether conventional or alternative – that has a biological or psychological effect on a patient may also have potential to possess dangerous biological or psychological side-effects. Alternative medicine_sentence_225

Attempts to refute this fact with regard to alternative therapies sometimes use the appeal to nature fallacy, i.e., "That which is natural cannot be harmful." Alternative medicine_sentence_226

Specific groups of patients such as patients with impaired hepatic or renal function are more susceptible to side effects of alternative remedies. Alternative medicine_sentence_227

An exception to the normal thinking regarding side-effects is Homeopathy. Alternative medicine_sentence_228

Since 1938, the U.S. Alternative medicine_sentence_229 Food and Drug Administration (FDA) has regulated homeopathic products in "several significantly different ways from other drugs." Alternative medicine_sentence_230

Homeopathic preparations, termed "remedies", are extremely dilute, often far beyond the point where a single molecule of the original active (and possibly toxic) ingredient is likely to remain. Alternative medicine_sentence_231

They are, thus, considered safe on that count, but "their products are exempt from good manufacturing practice requirements related to expiration dating and from finished product testing for identity and strength", and their alcohol concentration may be much higher than allowed in conventional drugs. Alternative medicine_sentence_232

Treatment delay Alternative medicine_section_33

Alternative medicine may discourage people from getting the best possible treatment. Alternative medicine_sentence_233

Those having experienced or perceived success with one alternative therapy for a minor ailment may be convinced of its efficacy and persuaded to extrapolate that success to some other alternative therapy for a more serious, possibly life-threatening illness. Alternative medicine_sentence_234

For this reason, critics argue that therapies that rely on the placebo effect to define success are very dangerous. Alternative medicine_sentence_235

According to mental health journalist Scott Lilienfeld in 2002, "unvalidated or scientifically unsupported mental health practices can lead individuals to forgo effective treatments" and refers to this as opportunity cost. Alternative medicine_sentence_236

Individuals who spend large amounts of time and money on ineffective treatments may be left with precious little of either, and may forfeit the opportunity to obtain treatments that could be more helpful. Alternative medicine_sentence_237

In short, even innocuous treatments can indirectly produce negative outcomes. Alternative medicine_sentence_238

Between 2001 and 2003, four children died in Australia because their parents chose ineffective naturopathic, homeopathic, or other alternative medicines and diets rather than conventional therapies. Alternative medicine_sentence_239

Unconventional cancer "cures" Alternative medicine_section_34

There have always been "many therapies offered outside of conventional cancer treatment centers and based on theories not found in biomedicine. Alternative medicine_sentence_240

These alternative cancer cures have often been described as 'unproven,' suggesting that appropriate clinical trials have not been conducted and that the therapeutic value of the treatment is unknown." Alternative medicine_sentence_241

However, "many alternative cancer treatments have been investigated in good-quality clinical trials, and they have been shown to be ineffective....The label 'unproven' is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been 'disproven'." Alternative medicine_sentence_242

Edzard Ernst has stated: Alternative medicine_sentence_243

Rejection of science Alternative medicine_section_35

"CAM", meaning "complementary and alternative medicine", is not as well researched as conventional medicine, which undergoes intense research before release to the public. Alternative medicine_sentence_244

Practitioners of science-based medicine also discard practices and treatments when they are shown ineffective, while alternative practitioners do not. Alternative medicine_sentence_245

Funding for research is also sparse making it difficult to do further research for effectiveness of CAM. Alternative medicine_sentence_246

Most funding for CAM is funded by government agencies. Alternative medicine_sentence_247

Proposed research for CAM are rejected by most private funding agencies because the results of research are not reliable. Alternative medicine_sentence_248

The research for CAM has to meet certain standards from research ethics committees, which most CAM researchers find almost impossible to meet. Alternative medicine_sentence_249

Even with the little research done on it, CAM has not been proven to be effective. Alternative medicine_sentence_250

Studies that have been done will be cited by CAM practitioners in an attempt to claim a basis in science. Alternative medicine_sentence_251

These studies tend to have a variety of problems, such as small samples, various biases, poor research design, lack of controls, negative results, etc. Alternative medicine_sentence_252

Even those with positive results can be better explained as resulting in false positives due to bias and noisy data. Alternative medicine_sentence_253

Alternative medicine may lead to a false understanding of the body and of the process of science. Alternative medicine_sentence_254

Steven Novella, a neurologist at Yale School of Medicine, wrote that government-funded studies of integrating alternative medicine techniques into the mainstream are "used to lend an appearance of legitimacy to treatments that are not legitimate." Alternative medicine_sentence_255

Marcia Angell considered that critics felt that healthcare practices should be classified based solely on scientific evidence, and if a treatment had been rigorously tested and found safe and effective, science-based medicine will adopt it regardless of whether it was considered "alternative" to begin with. Alternative medicine_sentence_256

It is possible for a method to change categories (proven vs. unproven), based on increased knowledge of its effectiveness or lack thereof. Alternative medicine_sentence_257

A prominent supporter of this position is George D. Lundberg, former editor of the Journal of the American Medical Association (JAMA). Alternative medicine_sentence_258

Writing in 1999 in CA: A Cancer Journal for Clinicians Barrie R. Cassileth mentioned a 1997 letter to the US Senate Subcommittee on Public Health and Safety, which had deplored the lack of critical thinking and scientific rigor in OAM-supported research, had been signed by four Nobel Laureates and other prominent scientists. Alternative medicine_sentence_259

(This was supported by the National Institutes of Health (NIH).) Alternative medicine_sentence_260

In March 2009, a staff writer for the Washington Post reported that the impending national discussion about broadening access to health care, improving medical practice and saving money was giving a group of scientists an opening to propose shutting down the National Center for Complementary and Alternative Medicine. Alternative medicine_sentence_261

They quoted one of these scientists, Steven Salzberg, a genome researcher and computational biologist at the University of Maryland, as saying "One of our concerns is that NIH is funding pseudoscience." Alternative medicine_sentence_262

They noted that the vast majority of studies were based on fundamental misunderstandings of physiology and disease, and had shown little or no effect. Alternative medicine_sentence_263

Writers such as Carl Sagan, a noted astrophysicist, advocate of scientific skepticism and the author of The Demon-Haunted World: Science as a Candle in the Dark (1996), have lambasted the lack of empirical evidence to support the existence of the putative energy fields on which these therapies are predicated. Alternative medicine_sentence_264

Sampson has also pointed out that CAM tolerated contradiction without thorough reason and experiment. Alternative medicine_sentence_265

Barrett has pointed out that there is a policy at the NIH of never saying something doesn't work, only that a different version or dose might give different results. Alternative medicine_sentence_266

Barrett also expressed concern that, just because some "alternatives" have merit, there is the impression that the rest deserve equal consideration and respect even though most are worthless, since they are all classified under the one heading of alternative medicine. Alternative medicine_sentence_267

Some critics of alternative medicine are focused upon health fraud, misinformation, and quackery as public health problems, notably Wallace Sampson and Paul Kurtz founders of Scientific Review of Alternative Medicine and Stephen Barrett, co-founder of The National Council Against Health Fraud and webmaster of Quackwatch. Alternative medicine_sentence_268

Grounds for opposing alternative medicine include that: Alternative medicine_sentence_269

Alternative medicine_unordered_list_1

  • It is usually based on religion, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, or fraud.Alternative medicine_item_1_7
  • Alternative therapies typically lack any scientific validation, and their effectiveness is either unproved or disproved.Alternative medicine_item_1_8
  • Treatments are not part of the conventional, science-based healthcare system.Alternative medicine_item_1_9
  • Research on alternative medicine is frequently of low quality and methodologically flawed.Alternative medicine_item_1_10
  • Where alternative therapies have replaced conventional science-based medicine, even with the safest alternative medicines, failure to use or delay in using conventional science-based medicine has caused deaths.Alternative medicine_item_1_11
  • Methods may incorporate or base themselves on traditional medicine, folk knowledge, spiritual beliefs, ignorance or misunderstanding of scientific principles, errors in reasoning, or newly conceived approaches claiming to heal.Alternative medicine_item_1_12

Many alternative medical treatments are not patentable, which may lead to less research funding from the private sector. Alternative medicine_sentence_270

In addition, in most countries, alternative therapies (in contrast to pharmaceuticals) can be marketed without any proof of efficacy – also a disincentive for manufacturers to fund scientific research. Alternative medicine_sentence_271

English evolutionary biologist Richard Dawkins, in his 2003 book A Devil's Chaplain, defined alternative medicine as a "set of practices that cannot be tested, refuse to be tested, or consistently fail tests." Alternative medicine_sentence_272

Dawkins argued that if a technique is demonstrated effective in properly performed trials then it ceases to be alternative and simply becomes medicine. Alternative medicine_sentence_273

CAM is also often less regulated than conventional medicine. Alternative medicine_sentence_274

There are ethical concerns about whether people who perform CAM have the proper knowledge to treat patients. Alternative medicine_sentence_275

CAM is often done by non-physicians who do not operate with the same medical licensing laws which govern conventional medicine, and it is often described as an issue of non-maleficence. Alternative medicine_sentence_276

According to two writers, Wallace Sampson and K. Butler, marketing is part of the training required in alternative medicine, and propaganda methods in alternative medicine have been traced back to those used by Hitler and Goebels in their promotion of pseudoscience in medicine. Alternative medicine_sentence_277

In November 2011 Edzard Ernst stated that the "level of misinformation about alternative medicine has now reached the point where it has become dangerous and unethical. Alternative medicine_sentence_278

So far, alternative medicine has remained an ethics-free zone. Alternative medicine_sentence_279

It is time to change this." Alternative medicine_sentence_280

Conflicts of interest Alternative medicine_section_36

Some commentators have said that special consideration must be given to the issue of conflicts of interest in alternative medicine. Alternative medicine_sentence_281

Edzard Ernst has said that most researchers into alternative medicine are at risk of "unidirectional bias" because of a generally uncritical belief in their chosen subject. Alternative medicine_sentence_282

Ernst cites as evidence the phenomenon whereby 100% of a sample of acupuncture trials originating in China had positive conclusions. Alternative medicine_sentence_283

David Gorski contrasts evidence-based medicine, in which researchers try to disprove hyphotheses, with what he says is the frequent practice in pseudoscience-based research, of striving to confirm pre-existing notions. Alternative medicine_sentence_284

Harriet Hall writes that there is a contrast between the circumstances of alternative medicine practitioners and disinterested scientists: in the case of acupuncture, for example, an acupuncturist would have "a great deal to lose" if acupuncture were rejected by research; but the disinterested skeptic would not lose anything if its effects were confirmed; rather their change of mind would enhance their skeptical credentials. Alternative medicine_sentence_285

Use of health and research resources Alternative medicine_section_37

Research into alternative therapies has been criticized for "...diverting research time, money, and other resources from more fruitful lines of investigation in order to pursue a theory that has no basis in biology." Alternative medicine_sentence_286

Research methods expert and author of Snake Oil Science, R. Alternative medicine_sentence_287 Barker Bausell, has stated that "it's become politically correct to investigate nonsense." Alternative medicine_sentence_288

A commonly cited statistic is that the US National Institute of Health had spent $2.5 billion on investigating alternative therapies prior to 2009, with none being found to be effective. Alternative medicine_sentence_289

Credits to the contents of this page go to the authors of the corresponding Wikipedia page: medicine.