From Dogs Naturally: Evidenced Based Medicine

[Wylie's Mom]

{{{ This article was PMd to me and the member asked that I post it here, as she was not comfortable posting this article due to its potentially controversial content. }}}

Link to article

Evidence Based Veterinary Medicine

Many of our posts, articles and authors seem to irritate vets and pet owners who are firmly entrenched in traditional medicine. By and large, the most common challenge they use against us is, “where are the scientific studies backing up your claims?”

It’s paradoxical that holistic medicine is unfairly held to a higher burden of proof than mainstream medicine. Do the vets and pet owners who accuse us of promoting medicine that lacks ‘scientific validity’ know that the majority of conventional drugs have an unknown mechanism of action?

One Golden Example

Some interesting examples from conventional human medicine include the 1950’s use of tetracycline (an antibiotic) in the treatment of rheumatoid arthritis on the theory that it was caused by infectious agents. This was discontinued when rheumatoid arthritis came to be thought of as an autoimmune disease and the standard treatment changed to gold compounds despite their mechanism of action being largely unknown.

The mechanism of action for acetylsalicylic acid, a compound found naturally in white willow bark, and better known as Aspirin, was not discovered until 1971, although it had been available commercially and prescribed since about 1899.

The mechanism of action is in fact unknown for large numbers of commonly prescribed drugs including statins, most psychotropic /psychiatric drugs like Lithium, acetaminophen and Lysodren (a common chemotherapy drug) and general anaesthetics. Would it then make sense to stop using those on surgical patients?

And this is by no means a comprehensive list.

It’s very common in the pharmaceutical industry for drugs to be in vogue for a particular condition, for a certain period of time and to later be found as useless, ineffective, dangerous, or more useful for some other condition than for which they were created.

Ironically, we don’t have that problem with homeopathic remedies or medicinal herbs. The same ones that worked 200 years ago still work today. On the same conditions.

Sadly, “evidence based medicine”, although an excellent concept, has been corrupted into a buzzword used to discredit the results of raw feeding, homeopathy and other so-called alternative health care methods. “Evidence based” means that data from randomized controlled studies provides certainty about whether a treatment will work and is safe. The reality is 66% of the treatment procedures and drugs that are commonly used in conventional medicine have no or little evidence to recommend them (British Medical Journal, 2007). Many procedures have serious complications and many drugs cause difficult and unwanted effects. It is these issues that drive pet owners toward less harmful and health promoting approaches in the first place.

Below is the breakdown of clinical evidence for 2,500 common medical treatments from the study in the British Medical Journal.*

{{{ SEE CHART ATTACHED BELOW }}}

That’s a big grey area on the left, isn’t it? Add “unlikely,” “likely to be ineffective or harmful,” and “trade-off,” and that’s two-thirds of conventional medical treatments that are dubious.

The situation is likely worse in animal medicine. Often, human drugs and medications that have failed human trials are subsequently solicited to the pet market. In addition, there is no formal requirement for reporting adverse reactions to pharmaceuticals in veterinary medicine.

The next time somebody defends conventional medicine by asking us for “scientific validity”, we might ask them the same question.

[107barney]

Can't access the link.

[Wylie's Mom]

Originally Posted by 107barney

Can't access the link.

Weird...I couldn't either that time .

Does this one work? It's All In The Evidence, Or Is It?

[mimimomo]

Originally Posted by Wylie's Mom

Weird...I couldn't either that time .

Does this one work? It's All In The Evidence, Or Is It?

It works, Thank you.

[pstinard]

Originally Posted by Wylie's Mom

Evidence Based Veterinary Medicine

Many of our posts, articles and authors seem to irritate vets and pet owners who are firmly entrenched in traditional medicine. By and large, the most common challenge they use against us is, “where are the scientific studies backing up your claims?”

It’s paradoxical that holistic medicine is unfairly held to a higher burden of proof than mainstream medicine. Do the vets and pet owners who accuse us of promoting medicine that lacks ‘scientific validity’ know that the majority of conventional drugs have an unknown mechanism of action?

One Golden Example

Some interesting examples from conventional human medicine include the 1950’s use of tetracycline (an antibiotic) in the treatment of rheumatoid arthritis on the theory that it was caused by infectious agents. This was discontinued when rheumatoid arthritis came to be thought of as an autoimmune disease and the standard treatment changed to gold compounds despite their mechanism of action being largely unknown.

The mechanism of action for acetylsalicylic acid, a compound found naturally in white willow bark, and better known as Aspirin, was not discovered until 1971, although it had been available commercially and prescribed since about 1899.

The mechanism of action is in fact unknown for large numbers of commonly prescribed drugs including statins, most psychotropic /psychiatric drugs like Lithium, acetaminophen and Lysodren (a common chemotherapy drug) and general anaesthetics. Would it then make sense to stop using those on surgical patients?

And this is by no means a comprehensive list.

It’s very common in the pharmaceutical industry for drugs to be in vogue for a particular condition, for a certain period of time and to later be found as useless, ineffective, dangerous, or more useful for some other condition than for which they were created.

Ironically, we don’t have that problem with homeopathic remedies or medicinal herbs. The same ones that worked 200 years ago still work today. On the same conditions.

Sadly, “evidence based medicine”, although an excellent concept, has been corrupted into a buzzword used to discredit the results of raw feeding, homeopathy and other so-called alternative health care methods. “Evidence based” means that data from randomized controlled studies provides certainty about whether a treatment will work and is safe. The reality is 66% of the treatment procedures and drugs that are commonly used in conventional medicine have no or little evidence to recommend them (British Medical Journal, 2007). Many procedures have serious complications and many drugs cause difficult and unwanted effects. It is these issues that drive pet owners toward less harmful and health promoting approaches in the first place.

Below is the breakdown of clinical evidence for 2,500 common medical treatments from the study in the British Medical Journal.*

{{{ SEE CHART ATTACHED BELOW }}}

That’s a big grey area on the left, isn’t it? Add “unlikely,” “likely to be ineffective or harmful,” and “trade-off,” and that’s two-thirds of conventional medical treatments that are dubious.

The situation is likely worse in animal medicine. Often, human drugs and medications that have failed human trials are subsequently solicited to the pet market. In addition, there is no formal requirement for reporting adverse reactions to pharmaceuticals in veterinary medicine.

The next time somebody defends conventional medicine by asking us for “scientific validity”, we might ask them the same question.

I was going to let this article pass without comment, but since it provides misinformation that could affect the health decisions that one makes for one's dog, it deserves a cursory examination.

First, this article creates a "straw man" type of argument. A straw man argument is defined as: "a common form of argument and is an informal fallacy based on false representation of an opponent's argument. To be successful, a straw man argument requires that the audience be ignorant or uninformed of the original argument." (From Straw man - Wikipedia, the free encyclopedia)

This article gives a false definition of "evidence based medicine." The actual definition of evidence based medicine is "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research." (From Evidence based medicine: what it is and what it isn't | The BMJ)

In other words, it is medicine that works in a practical sense on real patients. If a treatment doesn't work, it isn't evidence based medicine. This makes the graph accompanying the article rather puzzling and unhelpful. It doesn't help that the most important links embedded in the article don't work, and it's not possible to track down where that graph actually came from, or what it was meant to demonstrate.

Clearly, based on what evidence based medicine actually is, statements like the following aren't relevant:

"The mechanism of action is in fact unknown for large numbers of commonly prescribed drugs including statins, most psychotropic /psychiatric drugs like Lithium, acetaminophen and Lysodren (a common chemotherapy drug) and general anaesthetics. Would it then make sense to stop using those on surgical patients?"

This isn't evidence based medicine either:

"Often, human drugs and medications that have failed human trials are subsequently solicited to the pet market. In addition, there is no formal requirement for reporting adverse reactions to pharmaceuticals in veterinary medicine."

The original article DOES link to the following website on homeopathic medicine, which I suppose is the point of this article: - Home

Clearly, homeopathic medicine is subject to the same rules as evidence based medicine: Does it work?

I can't answer that question, but I will simply state that this article doesn't help explain what evidence based medicine is, and whether or not homeopathic medicine works.

[pstinard]

Since I met the character limit on the previous post, I couldn't give the more expanded definition of evidence based medicine. Here it is:

Evidence-based medicine has been defined by its proponents as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. In this definition, the practice of evidence-based medicine means integrating individual clinical expertise with a critical appraisal of the best available external clinical evidence from systematic research. By individual clinical expertise is meant the proficiency and judgment that individual clinicians acquire through clinical experience and clinical practice. Increased expertise is reflected in many ways, but especially in more effective and efficient diagnosis and in the more thoughtful identification and compassionate use of individual patients' predicaments, rights, and preferences in making clinical decisions about their care. By best available external clinical evidence is meant clinically relevant research, often from the basic sciences of medicine, but especially from patient-centered clinical research into the accuracy and precision of diagnostic tests (including the clinical examination), the power of prognostic factors, and the efficacy and safety of therapeutic, rehabilitative, and preventive regimens.

The practice of evidence-based medicine is a process of lifelong, self-directed learning in which caring for one's own patients creates the need for clinically important information about diagnosis, prognosis, therapy, and other clinical and health care issues, and in which its practitioners:

1. Convert these information needs into answerable questions.

2. Track down, with maximum efficiency, the best evidence with which to answer them (and making increasing use of secondary sources of the best evidence). Examples of such secondary sources are the Cochrane Library and journals of critically appraised clinical articles such as ACP Journal Club and Evidence-Based Medicine.

3. Critically appraise that evidence for its validity (closeness to the truth) and usefulness (clinical applicability).

4. Integrate the appraisal with clinical expertise and apply the results in clinical practice.

5. Evaluate one's own performance.

The rest of the article (probably behind paywall) is here: Evidence-based Medicine - Encyclopedia of Biostatistics - Sackett - Wiley Online Library

Nothing about quadruple-blind peer-reviewed studies conducted in the darkest recesses of pharmaceutical company basements here. Rather than erecting a bogeyman, I think it's important to know what evidence based medicine actually is.

[ladyjane]

Very thoughtful response, Phil. I know for me, it comes down to one thing....my dogs will never be guinea pigs. I want well thought out and tried and true methods of treatments for them.

Ann, no disrespect intended here, but I cannot think that you would believe this article is valid. I realize you did it for a member as you put that disclaimer on it. Yes, I realize you like all sides expressed, but you and I have the same professional background and I seirously doubt you bought this article. I would not post it for anyone, even at a price! I can see why that member would be uncomfortable posting it...he/she already knows it is controversial. That alone should raise a red flag to them!! I just wish people would realize that no one is just arbitrarily bashing them for their posts of these things. People try so hard to make others understand that much of this is simply not good information; and I know that I like to let people know for their good and the good of their pets. It scares me that things like this are so readily just accepted as gospel.

[Yorkiemom1]

Thank you Phil for the honest clarification of the article that was presented.

[gemy]

Originally Posted by


[B

Evidence-based medicine has been defined by its proponents as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. In this definition, the practice of evidence-based medicine means integrating individual clinical expertise with a critical appraisal of the best available external clinical evidence from systematic research. By individual clinical expertise is meant the proficiency and judgment that individual clinicians acquire through clinical experience and clinical practice. Increased expertise is reflected in many ways, but especially in more effective and efficient diagnosis and in the more thoughtful identification and compassionate use of individual patients' predicaments, rights, and preferences in making clinical decisions about their care. By best available external clinical evidence is meant clinically relevant research, often from the basic sciences of medicine, but especially from patient-centered clinical research into the accuracy and precision of diagnostic tests (including the clinical examination), the power of prognostic factors, and the efficacy and safety of therapeutic, rehabilitative, and preventive regimens.[/B]

The practice of evidence-based medicine is a process of lifelong, self-directed learning in which caring for one's own patients creates the need for clinically important information about diagnosis, prognosis, therapy, and other clinical and health care issues, and in which its practitioners:

1. Convert these information needs into answerable questions.

2. Track down, with maximum efficiency, the best evidence with which to answer them (and making increasing use of secondary sources of the best evidence). Examples of such secondary sources are the Cochrane Library and journals of critically appraised clinical articles such as ACP Journal Club and Evidence-Based Medicine.

3. Critically appraise that evidence for its validity (closeness to the truth) and usefulness (clinical applicability).

4. Integrate the appraisal with clinical expertise and apply the results in clinical practice.

5. Evaluate one's own performance.

The rest of the article (probably behind paywall) is here: Evidence-based Medicine - Encyclopedia of Biostatistics - Sackett - Wiley Online Library

Nothing about quadruple-blind peer-reviewed studies conducted in the darkest recesses of pharmaceutical company basements here. Rather than erecting a bogeyman, I think it's important to know what evidence based medicine actually is.

Thanks Phil for posting this more complete definition of what is meant by evidence based medicine. It is interesting to take note of the fact that clinical personal experience is highly factored into an evidenced based approach. There is nothing in the above definition that precludes naturopathic or homeopathic doctors from practising an evidence based approach. With the glaring exception of the fact that the body of scientific studies for herbal remedies (of one nature or another has not been built).


In my reading of the article below this person was not providing a definition of Evidence Based Veterinary Medicine in its totality - but as asserted in the first paragragh speaking to a specific question that they get quite commonly - ergo - where are the studies backing up your claims? And I have no doubt that is a question they often get! Certainly one I would ask.

I believe it is a common conception (perhaps misconception) that there are scientific studies in traditional medicine to back up every treatment plan a vet or an MD makes. This article is pointing out the fact that this is patently not so. Is this assertion valid? IDK. But common sense tells me it is so.


The author focussed on mechanism of action being unknown for many drugs out there. Is this a true statement of fact? IDK - How important is it to know the mechanism of action before prescribing a drug? Marketing it? Or is it more important to know that it works on some of the ppl some of the time - and if over time it is shown to be ineffective for condition a/b/c then you stop prescribing it.


I have a question for you Phil - I have heard recently that Canada and the USA signed an international agreement years ago - 15 or more years ago - signed an accord that said - the funders of the research *own the research* - and that includes publishing or not the results of the study. As of yet I have not been able to confirm that assertion. If true that is very disturbing to me.


Homeopathic medicine has a huge body of clinical experience available to the doctors of said medicine. At least that is my understanding.


I how-ever agree that this article whilst pointing out some of the short-comings of Western medicine does nothing to advance the validity of homeopathic or naturopathic discipline.





Evidence Based Veterinary Medicine

Many of our posts, articles and authors seem to irritate vets and pet owners who are firmly entrenched in traditional medicine. By and large, the most common challenge they use against us is, “where are the scientific studies backing up your claims?�

It’s paradoxical that holistic medicine is unfairly held to a higher burden of proof than mainstream medicine. Do the vets and pet owners who accuse us of promoting medicine that lacks ‘scientific validity’ know that the majority of conventional drugs have an unknown mechanism of action?

One Golden Example

Some interesting examples from conventional human medicine include the 1950’s use of tetracycline (an antibiotic) in the treatment of rheumatoid arthritis on the theory that it was caused by infectious agents. This was discontinued when rheumatoid arthritis came to be thought of as an autoimmune disease and the standard treatment changed to gold compounds despite their mechanism of action being largely unknown.

The mechanism of action for acetylsalicylic acid, a compound found naturally in white willow bark, and better known as Aspirin, was not discovered until 1971, although it had been available commercially and prescribed since about 1899.

The mechanism of action is in fact unknown for large numbers of commonly prescribed drugs including statins, most psychotropic /psychiatric drugs like Lithium, acetaminophen and Lysodren (a common chemotherapy drug) and general anaesthetics. Would it then make sense to stop using those on surgical patients?

And this is by no means a comprehensive list.

It’s very common in the pharmaceutical industry for drugs to be in vogue for a particular condition, for a certain period of time and to later be found as useless, ineffective, dangerous, or more useful for some other condition than for which they were created.

Ironically, we don’t have that problem with homeopathic remedies or medicinal herbs. The same ones that worked 200 years ago still work today. On the same conditions.

Sadly, “evidence based medicine�, although an excellent concept, has been corrupted into a buzzword used to discredit the results of raw feeding, homeopathy and other so-called alternative health care methods. “Evidence based� means that data from randomized controlled studies provides certainty about whether a treatment will work and is safe. The reality is 66% of the treatment procedures and drugs that are commonly used in conventional medicine have no or little evidence to recommend them (British Medical Journal, 2007). Many procedures have serious complications and many drugs cause difficult and unwanted effects. It is these issues that drive pet owners toward less harmful and health promoting approaches in the first place.

Below is the breakdown of clinical evidence for 2,500 common medical treatments from the study in the British Medical Journal.*

{{{ SEE CHART ATTACHED BELOW }}}

That’s a big grey area on the left, isn’t it? Add “unlikely,� “likely to be ineffective or harmful,� and “trade-off,� and that’s two-thirds of conventional medical treatments that are dubious.

The situation is likely worse in animal medicine. Often, human drugs and medications that have failed human trials are subsequently solicited to the pet market. In addition, there is no formal requirement for reporting adverse reactions to pharmaceuticals in veterinary medicine.

The next time somebody defends conventional medicine by asking us for “scientific validity�, we might ask them the same question.




Thanks Ann for posting this article - although finding the links were tough.

[pstinard]

Originally Posted by Yorkiemom1

Thank you Phil for the honest clarification of the article that was presented.

Thanks! I can understand WHY the article was written. Proponents of homeopathic medicine feel like they are under attack from the traditional medical community, and they are fighting back. However, BOTH sides need to realize that smear campaigns, name calling, and misrepresenting their opponent are not helpful or acceptable. It would be great if both sides could present the positive aspects of their sides, and if they have criticisms of their opponents, it would be fantastic if they could present their criticisms in a constructive, reasonable manner . No more talk of "tendrils of woo," "bulls**t," "evil empires," and "big pharma," please! I can understand the frustration, but please, really!

[ladyjane]

Originally Posted by pstinard

Thanks! I can understand WHY the article was written. Proponents of homeopathic medicine feel like they are under attack from the traditional medical community, and they are fighting back. However, BOTH sides need to realize that smear campaigns, name calling, and misrepresenting their opponent are not helpful or acceptable. It would be great if both sides could present the positive aspects of their sides, and if they have criticisms of their opponents, it would be fantastic if they could present their criticisms in a constructive, reasonable manner . No more talk of "tendrils of woo," "bulls**t," "evil empires," and "big pharma," please! I can understand the frustration, but please, really!

I agree. There is a place for both. I know that I use some homeopathic "cures" but I don't agree that they will ever be a total replacement "for". I really think this comes down to almost a political thing....far right vs far left. The extremes always make it look bad for the mainstream.

[ladyjane]

One of my favorite examples of mixing homeopathic with traditional medicine is one of my former pups who has since left me due to renal failure. He came to me at the age of 8 with horrible skin issues. For those who have seen these photos before, I apologize; but I think he is such an excellent example ...

Index of /cody (the first two links are his before and after)

Cody had bacterial and fungal infections. My vet prescribed an antibiotic for the bacterial infection but not an anti fungal. She told me to bathe him 3 times/week and then rinse him in 50/50 warm vinegar and water. I remember questioning her because I felt he should have an anti fungal, but she insisted it would work and felt it was better than to use the medication. It was amazing! He started to respond after the first week...and I so remember when he started growing hair on his little bare chest. I remember telling him that he was going through puberty. LOL

Since that day/experience I have had many pups with allergy issues who have had fungal infections and to this day I have never given an anti fungal. I had a member here who once told me that tea bags cure staph infections ... to me that is way off the beaten path. We know for a fact that antibiotics cure bacterial infections. Maybe if you get to something early, you can get away with homeopathic but certainly not once an infection has set in/taken hold.

Just one example...but I think it is a good one especially since the photos are really a great overall picture of it.

[pstinard]

Originally Posted by gemy

Thanks Phil for posting this more complete definition of what is meant by evidence based medicine. It is interesting to take note of the fact that clinical personal experience is highly factored into an evidenced based approach. There is nothing in the above definition that precludes naturopathic or homeopathic doctors from practising an evidence based approach. With the glaring exception of the fact that the body of scientific studies for herbal remedies (of one nature or another) has not been built.

My point exactly! Alternative methods CAN be evidence based. They simply need need to build a data set (case studies, etc.) that show that their approach works. That's all evidence based medicine is asking: Does it work? The "why" can be worked out later.

Originally Posted by gemy

In my reading of the article below this person was not providing a definition of Evidence Based Veterinary Medicine in its totality - but as asserted in the first paragragh speaking to a specific question that they get quite commonly - ergo - where are the studies backing up your claims? And I have no doubt that is a question they often get! Certainly one I would ask.

Originally Posted by gemy

I believe it is a common conception (perhaps misconception) that there are scientific studies in traditional medicine to back up every treatment plan a vet or an MD makes. This article is pointing out the fact that this is patently not so. Is this assertion valid? IDK. But common sense tells me it is so.

Yes, exactly! But traditional medical approaches that have failed are NOT evidence based medicine. Evidence based medicine is a recent concept that (believe it or not) was developed in the 1990's, and a lot of older, failed approaches still need to be held up to higher standards and discarded if they don't really work.

Originally Posted by gemy

The author focussed on mechanism of action being unknown for many drugs out there. Is this a true statement of fact? IDK - How important is it to know the mechanism of action before prescribing a drug? Marketing it? Or is it more important to know that it works on some of the ppl some of the time - and if over time it is shown to be ineffective for condition a/b/c then you stop prescribing it.

No, the mechanism of action of MOST drugs is known--the article was pointing out a few examples of drugs for which the mechanism was not known at the time they were developed. The most important question is "does it work?" but obviously it helps if they know the mechanism, because it makes it easier to develop more useful drugs, as well as to know the interactions with other drugs that might result in side effects.

The reason they were making this point is that the mechanism of homeopathic medicine is not understood, either. And that's okay, IF there is a body of evidence that shows that it works. Mechanisms can be worked out later.

Originally Posted by gemy

I have a question for you Phil - I have heard recently that Canada and the USA signed an international agreement years ago - 15 or more years ago - signed an accord that said - the funders of the research *own the research* - and that includes publishing or not the results of the study. As of yet I have not been able to confirm that assertion. If true that is very disturbing to me.

My next research project . I will see if I can find out for you. My understanding is that if a drug is going to be marketed, they HAVE to publish the data that proves that it works, or make it available to the regulatory agencies (not all data is worthy of publication). The manufacturing techniques, though, are trade secrets, and they don't have to reveal those. They do have to prove safety and effectiveness of the final product, though.

Originally Posted by gemy

Homeopathic medicine has a huge body of clinical experience available to the doctors of said medicine. At least that is my understanding.

Originally Posted by gemy

I how-ever agree that this article whilst pointing out some of the short-comings of Western medicine does nothing to advance the validity of homeopathic or naturopathic discipline.

Thanks Ann for posting this article - although finding the links were tough.

Yes, and smearing evidence based medicine is definitely something they DON'T want to do. Otherwise, how can they show that their approach works? You can't have it both ways. (Sorry for the strange way the quotes are handled in this post--I can't fix them.)

[Wylie's Mom]

Originally Posted by gemy

Thanks Phil for posting this more complete definition of what is meant by evidence based medicine. It is interesting to take note of the fact that clinical personal experience is highly factored into an evidenced based approach. There is nothing in the above definition that precludes naturopathic or homeopathic doctors from practising an evidence based approach. With the glaring exception of the fact that the body of scientific studies for herbal remedies (of one nature or another has not been built).


In my reading of the article below this person was not providing a definition of Evidence Based Veterinary Medicine in its totality - but as asserted in the first paragragh speaking to a specific question that they get quite commonly - ergo - where are the studies backing up your claims? And I have no doubt that is a question they often get! Certainly one I would ask.

I believe it is a common conception (perhaps misconception) that there are scientific studies in traditional medicine to back up every treatment plan a vet or an MD makes. This article is pointing out the fact that this is patently not so. Is this assertion valid? IDK. But common sense tells me it is so.


The author focussed on mechanism of action being unknown for many drugs out there. Is this a true statement of fact? IDK - How important is it to know the mechanism of action before prescribing a drug? Marketing it? Or is it more important to know that it works on some of the ppl some of the time - and if over time it is shown to be ineffective for condition a/b/c then you stop prescribing it.


I have a question for you Phil - I have heard recently that Canada and the USA signed an international agreement years ago - 15 or more years ago - signed an accord that said - the funders of the research *own the research* - and that includes publishing or not the results of the study. As of yet I have not been able to confirm that assertion. If true that is very disturbing to me.


Homeopathic medicine has a huge body of clinical experience available to the doctors of said medicine. At least that is my understanding.


I how-ever agree that this article whilst pointing out some of the short-comings of Western medicine does nothing to advance the validity of homeopathic or naturopathic discipline.

Thanks Ann for posting this article - although finding the links were tough.

This is similar to how I read/interpreted the article as well.

[SirTeddykins]

Originally Posted by pstinard

My point exactly! Alternative methods CAN be evidence based. They simply need need to build a data set (case studies, etc.) that show that their approach works. That's all evidence based medicine is asking: Does it work? The "why" can be worked out later.



Yes, exactly! But traditional medical approaches that have failed are NOT evidence based medicine. Evidence based medicine is a recent concept that (believe it or not) was developed in the 1990's, and a lot of older, failed approaches still need to be held up to higher standards and discarded if they don't really work.



No, the mechanism of action of MOST drugs is known--the article was pointing out a few examples of drugs for which the mechanism was not known at the time they were developed. The most important question is "does it work?" but obviously it helps if they know the mechanism, because it makes it easier to develop more useful drugs, as well as to know the interactions with other drugs that might result in side effects.

The reason they were making this point is that the mechanism of homeopathic medicine is not understood, either. And that's okay, IF there is a body of evidence that shows that it works. Mechanisms can be worked out later.



My next research project . I will see if I can find out for you. My understanding is that if a drug is going to be marketed, they HAVE to publish the data that proves that it works, or make it available to the regulatory agencies (not all data is worthy of publication). The manufacturing techniques, though, are trade secrets, and they don't have to reveal those. They do have to prove safety and effectiveness of the final product, though.



Yes, and smearing evidence based medicine is definitely something they DON'T want to do. Otherwise, how can they show that their approach works? You can't have it both ways. (Sorry for the strange way the quotes are handled in this post--I can't fix them.)

I almost bit my own hand off trying to not respond so thank you for taking the initiative!


Yes, it is important to understand how/if/why the medicine is targeting the appropriate pathways and networks and this is important in pathological and psychological medicines.


Even if it is not immediately known, this is always investigated once the efficacy has been established. It would be unethical, otherwise, to recommend or market the medication ... Yes, I know that after the fact a lot of meds are recalled or there is a development in the efficacy or lack thereof but that just goes to show that research is ongoing, even for 'approved' medicines and that we continually have to readjust our expectations and recommendations re: certain meds.


Okay, my mouth is now empty of hand.