Docstoc

cam

Document Sample
cam Powered By Docstoc
					Will duct tape cure my warts?
 Examining Complementary
     and Alternative Medicine


                                Karen Vargas
        Consumer Health Outreach Coordinator

      National Network of Libraries of Medicine
                         South Central Region
Agenda
• Introducing CAM

• Evaluating Web Sites

• Recommended Websites

• Reviewing the Evidence
      garlic pills                   cabbage
                     alfalfa pills
     castor oil                           e
iodine                     banana peel
        toothpaste
   How do you get rid of a wart?
       potato silk thread
                            nail polish
 duct tape
                raw meat witch hazel
dandelion juice
                 cigarette ashes aloe
  apple cider
 c         orange peel       quarters
What is CAM?
• Complementary and Alternative Medicine

• Complementary: together with
   – aromatherapy to help with pain after surgery


• Alternative: in place of
   – using garlic to lower blood pressure
CAM becomes “legit”
• 1990
  – Wilk et al v. AMA

• 1991
  – $2 million in funding to establish NIH Office of
    Alternative Medicine

• 1994
  – Dietary Supplement Health and Education Act
CAM becomes “legit”
• 1995
  – NIH Office of Dietary Supplements
  – FDA declassifies Acupuncture
    needles as experimental product

• 1996
  – NIH Consensus Conference on Acupuncture

• 1997
  – First large trial of CAM therapy, St. John’s Wort
    for depression
CAM becomes “legit”
• 1998
  – National Center for Complementary &
    Alternative Medicine (NCCAM) established
    http://nccam.nih.gov/
  – First full scale article in JAMA on herbal medicine
  – Office of Cancer Complementary and Alternative
    Medicine (OCCAM) established
    http://www.cancer.gov/cam/

• 2001
  – CAM on PubMed (NCCAM and NLM)

• 2009 - $296 million in NIH CAM research
Impact of CAM
• CDC Report (2007)
  – 38% of adults used some form of CAM
  – Children whose parent used CAM were 2x as likely
    to have used CAM
  – CAM use more prevalent for: women, adults aged
    30-69, higher levels of education, adults who were
    not poor, adults living in the West, and former
    smokers

• Full report:
  http://nccam.nih.gov/news/camstats/
Diseases and Conditions
Top CAM Therapies
Top 10 Supplements
           Categorization of Therapies
•    Whole Medical Systems
•    Biologically Based Practices
•    Energy Medicine
•    Manipulative and Body-Based Practices
•    Mind-Body Medicine




National Center of Complementary and Alternative Medicine
           Whole Medical Systems
• Complete systems of theory and practice
  that evolved independently
• Traditional systems of medicine that are
  practiced by individual cultures throughout
  the world
      – Includes traditional Chinese
        medicine, Ayurvedic medicine,
        homeopathy, naturopathy

National Center of Complementary and Alternative Medicine
           Biologically Based Practices
• Includes: botanicals, animal-derived extracts,
  vitamins, minerals, fatty acids, amino acids,
  proteins, whole diets, and functional foods
      – Dietary supplements are a subset
        of biologically based practices




National Center of Complementary and Alternative Medicine
Biologically Based - Supplements
• What is a supplement?

• Regulated by FDA http://www.fda.gov
  – no requirements for FDA testing
  – manufacturers responsible for ensuring
    product safety
  – label requirements

• Safety alerts:
  http://www.cfsan.fda.gov/~dms/ds-warn.html
Energy Medicine
• Veritable - energy that can be
  measured
      – Includes sound, visible light, magnetism

• Putative – energy that has yet to be
  measured
      – human beings are infused with a subtle form of
        energy
      – Includes qi (ki in Japanese); doshas; prana,
        homeopathic resonance
National Center of Complementary and Alternative Medicine
Energy Medicine - Acupuncture
• Few complications
• Scientific evidence?
  – post chemotherapy management of nausea
  – pain relief
• NIH Consensus Statement (1997)
  – http://consensus.nih.gov/1997/1997Acupuncture1
    07html.htm
            Manipulative and Body-Based
• Structures and systems of the body,
  including the bones and joints, the soft
  tissues, and the circulatory and lymphatic
  systems
      – Includes chiropractic manipulation,
        massage therapy, reflexology,
        rolfing, Alexander technique,
        Feldenkrais method

*National Center of Complementary and Alternative Medicine
Mind-Body Medicine
• Interactions among the brain,
  mind, body, and behavior

• The ways in which emotional, mental, social,
  spiritual, and behavioral factors can directly
  affect health
      – Includes relaxation, hypnosis, visual imagery,
        meditation, yoga, biofeedback, tai chi, group
        support, and spirituality
*National Center of Complementary and Alternative Medicine
Other CAM Therapies
•   Aromatherapy
•   Colonic Irrigation
•   Therapeutic Touch
•   EDTA Chelation
•   Cupping
•   Primordial Sound Meditation
Avoiding Bad Science
• The “One Product Does It All” claim
  http://www.emuoilcanada.com/
• Personal Testimonials
  http://www.getslimslippers.com/
• Quick Fixes/Cures
  http://www.improveyourhealthonline.com/
• The “No Risk Money Back Guarantee”
  http://www.naturalhpvcure.com/
• The “Natural” claim
  http://www.amtrueman.com/products.html
Evaluating Web Sites

 • Accuracy
 • Authority
 • Bias
 • Currency
 • Coverage
Evaluation Exercises
Recommended Websites




           About Herbs, Botanicals &
           Other Products
Examining the Research
• Observational Studies
• Clinical Trials/Studies
  – controlled
  – blind/double-blind
  – randomized

• ClinicalTrials.gov
  – Government and private clinical studies
    involving humans
  – http://clinicaltrials.gov
Clinical Trials and CAM

• Drug companies vs. supplement companies
• Customization of treatment in CAM
• CAM does not necessarily want to be
 studied
• CAM has only recently become “legit” in the
 scientific community
Money to fund CAM
• NCCAM: $121.7 million (2009)
• OCCAM: $121.9 million (2009)
  – Total all NIH: $296 million

• What about funding for pharmaceuticals?
  – $65.2 billion on R&D (2008) by drug companies
  – $114.4 billion on R&D (2008) by NIH (this
    includes NCCAM and OCCAM)
The other side
• Some say CAM research should not be
  funded
  – http://www.nccamwatch.org/ (Stephen Barrett)

• Or some CAM research should not be funded
  – http://tinyurl.com/46ayhjj
Reviewing the Evidence
• Evidence Based Medicine: “What evidence
  do we have to justify the treatment…”
• National Center for Complementary and
  Alternative Medicine (NCCAM)
• CAM on PubMed http://pubmed.gov
CAM on PubMed Exercises
               Questions?

             Karen Vargas
  karen.vargas@exch.library.tmc.edu


National Network of Libraries of Medicine
          South Central Region
             800-338-7657

				
DOCUMENT INFO