Methodological approaches to investigating the safety of complementary medicine

https://doi.org/10.1016/S0965-2299(98)80002-2Get rights and content

Summary

Complementary therapies are often believed to be entirely safe, yet the safety of a particular therapy or remedy can only be determined by evidence and not belief. The aim of this article is to outline briefly the methodological options available for researching the safety of complementary therapies. These tools include assessing historical use (the ‘test of time’), controlled clinical trials, systematic and narrative reviews, spontaneous-reporting schemes, epidemiological investigations, such as cohort studies, case-control studies, case registers, surveys, and outcomes studies. Each of these methods has its strengths and weaknesses. The best methodological approach will depend on the exact research question and the particular situation to be investigated. The safety issue in complementary medicine is grossly underresearched and the use of these methods in determining the safety of complementary therapies should be encouraged.

References (31)

  • MacLennanAH et al.

    Prevalence and cost of alternative medicine in Australia

    Lancet

    (1996)
  • ErnstE

    Life-threatening adverse reactions after acupuncture? A systematic review

    Pain

    (1997)
  • FisherP et al.

    Complementary medicine in Europe

    Br Med J

    (1994)
  • EisenbergDM et al.

    Unconventional medicine in the United States. Prevalence, costs and patterns of use

    New Eng J Med

    (1993)
  • Complementary medicines

  • ErnstE et al.

    Nine possible reasons for choosing complementary medicine

    Perfusion

    (1995)
  • RampesH et al.

    Complications of acupuncture

    Acupunct Med

    (1995)
  • LeeKH et al.

    Neurologic complications following chiropractic manipulation

    Neurology

    (1995)
  • ErnstE et al.

    Risks associated with complementary therapies

  • MonkB

    Severe cutaneous reations to alternative remedies

    Br Med J

    (1986)
  • AbbotNC et al.

    Complementary medicine

    Nature

    (1996)
  • De SmetPAGM

    Health risks of herbal remedies

    Drug Safety

    (1995)
  • RawlinsMD

    Pharmacovigilance: paradise lost, regained or postponed?

    J Roy Coll Physicians London

    (1995)
  • LindeK et al.

    St John's wort for depression — an overview and meta-analysis of randomised clinical trials

    Br Med J

    (1996)
  • WheatleyD

    LI 160, an extract of St John's wort, versus amitriptyline in mildly to moderately depressed outpatients — a controlled 6-week clinical trial

    Pharmacopsychiatry

    (1997)
  • Cited by (17)

    • Evaluation of healing by gentle touch in 35 clients with cancer

      2004, European Journal of Oncology Nursing
    • Integration and paradigm clash: The practical difficulties of integrative medicine

      2017, Mainstreaming Complementary and Alternative Medicine: Studies in Social Context
    • CAM and fibromyalgia: Possible research questions and research methods

      2010, Focus on Alternative and Complementary Therapies
    View all citing articles on Scopus
    *

    Edzard Ernst Department of Complementary Medicine, Division of Community Health Science, Postgraduate Medical School, University of Exeter, 25 Victoria Park Road, Exeter EX4 4NT UK.

    View full text