I got an email this morning from the content director at rVita.com, which is a new site aiming to provide good-quality information on complimentary and alternative medicine. It does this based on the research summaries at Natural Standard; user feedback; and expert advice.
I have to say, it’s a great idea, and I’ll be watching to see if the execution matches the concept. Potential problems I can see are:
1. Natural Standard is, quite rightly, reserved in its recommendations, erring on the side of caution with very high standards of evidence. By the nature of complementary and alternative medicine – which is mostly practiced by individual practitioners, who have little scientific training, on a small, local scale – there is a dearth of clear evidence of the effectiveness of most CAM treatments. This means that the data drawn from Natural Standard may well understate the effectiveness of some treatments (while being dead accurate on the lack of effectiveness of others). Also, experimental designs which are valid for drug treatments may not be as suited to assessing other forms of therapy, particularly if hard-to-quantify human factors (such as trust and emotional connection) form part of the effectiveness of the therapy.
2. The “web 2.0″ model of aggregating user experience can work well or badly depending on the user population. At best, it produces truly useful information that you couldn’t have got any other way. At worst, it is pooled ignorance. An individual person’s experience is also not a piece of scientific evidence; nor is that of a self-selected group. And the process is subject to hijacking by people with agendas, as Wikipedia proves on a daily basis.
3. “Experts” in CAM are usually making their living from it and are therefore motivated to overstate the effectiveness of the therapies they practice.
That’s the negative. The positive is that someone is at least trying this.
I hesitate to identify myself too strongly with the “complementary and alternative medicine” label, largely because there’s a lot of pseudoscience and simple nonsense being marketed under it. This is at least an honest attempt to challenge that. On one hand, there are many scientifically ignorant practitioners selling ineffective remedies to people who are looking for a magical solution to their problems. On the other, there are scientifically trained people who should know better closing their minds to anything even remotely alternative to drugs and surgery. (The term of dismissal I have seen around the net is “woo”, which often seems to mean “we don’t need to consider this scientifically because it doesn’t treat a human being as a machine”.)
I try to stand somewhere in the middle. Most of what I write here is relatively uncontroversial (which probably reduces my audience relative to people at the extremes). I mainly recommend lifestyle changes that are universally agreed by mainstream health science to be associated with improved health and wellbeing. Where I differ from some medical authorities and public health advocates is in deprecating drug-based solutions where non-drug alternatives, like hypnotherapy, exist and have evidence of effectiveness. My aim is the “health 2.0” aim of restoring a measure of responsibility for health to the people whose health it is, both informing them and putting them in a position to act on the information – giving them both a map and walking shoes.
I applaud rVita for its attempt at accurate mapmaking, and I will be watching to see how it goes.
Technorati Tags: health, health 2.0, web 2.0, CAM, complementary medicine, alternative medicine, evidence-based medicine, research, clinical trials, experimental design
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