Fw: Moving Alternative Medicine into Evidence-Based Medicine in the21st Century ...

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From: Ilena Rose <ilena@...>

Sent: Saturday, February 24, 2001 4:09 PM

Subject: Moving Alternative Medicine into Evidence-Based Medicine in the21st

Century ...

> http://biz./bw/010223/0253.html

>

>

> Press Release

>

> Moving Alternative Medicine into Evidence-Based Medicine in the 21st

> Century: Study in Journal of Alternative & Complementary Medicine Takes a

> First Step

>

> LARCHMONT, New York--(BW HealthWire)--Feb. 23, 2001-- Ann Liebert,

Inc.:

>

> Feasibility Study on Analysis and Benefits of Alternative

>

> Cancer Treatments Shows Need for Better Documentation to

>

> Evaluate and Compare Clinical Outcomes

>

> Nearly seven in ten cancer patients in the U.S. have used complementary or

> alternative medicine, most often in combination with conventional

> therapies. Surveys across 13 countries indicate that complementary and

> alternative treatments are used by 7 to 64 percent of all cancer patients.

> Reports of extraordinary survival ascribed to such therapies have long

> been made, but full and formal medical documentation of these results is

> too often lacking.

>

> ``The established medical community is demanding regulations and insisting

> that the promotion and sale of alternative therapies be subjected to the

> same standards of evaluation as other therapies,'' says the report of a

> new pilot study that tested the feasibility of performing outcomes and

> more advanced research for cancer patients at two complementary and

> alternative (CAM) clinics. The paper, entitled ``Assessment of Outcomes at

> Alternative Medicine Cancer Clinics: A Feasibility Study,'' by Ann

> , Dr.Ph.; C. , M.P.H.; Tina , M.S.;

> Barrett, Ph.D.; and Salveson, R.N., Ph.D., appears in The

> Journal of Alternative & Complementary Medicine: Research on Paradigm,

> Practice and Policy, Vol. 7, No. 1, published by Ann Liebert, Inc.

>

> The paper may be viewed online at

http://www.liebertpub.com/acm/acmpaper1.pdf.

>

> Because interest in alternative medicine is here to stay, say the authors,

> scientific testing is the next logical step. Their study is an analysis of

> what must be done by practitioners and researchers for such testing to be

> successfully implemented. Its findings indicate that effective survival

> analysis or any other qualitative assessments of clinical benefit at CAM

> clinics will demand improved record-keeping systems.

>

> ``Given the current interest in CAM and the growing demand by patients for

> reliable information on the benefit of these treatments, documentation and

> outcome assessment are critical,'' say the authors. ``With systematic

> evaluation of clinical outcomes, we can move the field of alternative

> medicine into evidence-based medicine for the twenty-first century.''

>

> The study's three primary objectives were to determine the feasibility of

> (1) obtaining and collecting data from medical records, (2) determining

> five-year survival, and (3) comparing five-year survival to that of

> conventionally treated cancer patients who sought alternative treatments

> at the two clinics in 1992. The report presents the barriers to achieving

> these goals and recommends strategies for facilitating high-quality

> research.

>

> ``Historical, widespread use of clinics such as these with anecdotal

> reports of extraordinary survival merit prospective, systematic monitoring

> of patient outcomes,'' concludes the study. ``For data to be meaningful,

> however, disease status must be pathologically confirmed and patient

> follow-up improved.''

>

> Accurate, Meticulous Records Are Keys to Documenting Alternative

Treatments

>

> The two CAM clinics chosen for the study, which have provided alternative

> cancer treatments for more than three decades, are The Bio-Medical Center

> in Tijuana, Mexico, and the Livingston Foundation Medical Center in San

> Diego, California.

>

> ``Although there are very interesting and potentially significant survival

> data in patients who attended either one of the clinics,'' says Journal

> Editor-in-Chief Kim Jobst, ``the data missing from the records of the

> Mexico center demonstrate that this makes it impossible to draw any

> conclusion other than that more work needs to be done. The pathological

> certification of diagnosis in the San Diego clinic cases, however,

> demonstrated the added value of such confirmation and verification to

> objective assessment. Until and unless these principles of accuracy and

> meticulous record-keeping are embraced in evaluation of any intervention,

> anecdotal evidence will continue to be used against new ideas rather than

> being the forerunner and argument for more rigorous exploration.

>

> ``The study also endorses the cry from many that longitudinal

> pragmatic follow-up studies of patients, with careful documentation of

> their treatment and dietary choices, are long overdue,'' says Dr. Jobst in

> his introductory editorial. ``It is heartening that such Prospective

> Outcomes Monitoring Systems are a priority for the National Center for

> Complementary & Alternative Medicine in the U.S.A. There have been calls

> for this in the U.K. and Europe for some time now.'' Dr. Jobst is

> affiliated with the Glasgow Nuffield Hospital in Scotland and is a

> professor of healthcare and integrated medicine at Oxford s

> University in Oxford, England.

>

> ``We chose these clinics because they have a collective history of sixty

> years of treating cancer patients--usually those who have exhausted

> conventional treatment--but more importantly, because they were willing to

> provide full and open access to all patient charts, endorse the study to

> patients, and reevaluate their clinical outcome assessment and

> documentation procedures,'' says lead author Ann . ``As

> more alternative practitioners and conventional researchers collaborate in

> the proposed Prospective Outcomes Monitoring System, the resulting

> preliminary data and field experience will provide the prerequisites to

> advance the field with more rigorous research and thus more definitive

> answers about efficacy.''

>

> At both clinics, patients included in the study were equally divided by

> gender and predominantly Caucasian, married, and U.S. residents. On

> average, they were 51 to 54 years old and within a year of diagnosis for

> breast, colorectal, lung, or male genital cancer. More than 60 percent

> arrived with distant or regional disease after conventional surgery and/or

> chemotherapy/radiotherapy. Survival at five years was able to be

> determined for 57 percent of patients at the Bio-Medical Center and 94.8

> percent at Livingston. However, the limited number of cases by cancer site

> prevented comparison to conventional treatment.

>

> The Bio-Medical Center in Tijuana, Mexico

>

> Subjects were 307 new patients treated for cancer during 1992, for 89.6

> percent of whom charts were available. 149 patients (54 percent) were

> treated for cancer and 43.6 percent of cases were confirmed by pathology

> reports. Survival at five years was determined for 57.0 percent; 11.4

> percent of the patients studied were living and 45.6 percent deceased.

>

> Since 1963, the Bio-Medical Center has treated cancer patients with a

> proprietary herbal tonic, external powders, and a special diet

> incorporating yeast tablets, vitamins, and garlic. This treatment,

> developed by Harry Hoxsey (1901-1974) in the 1920s, became widely

> available in 17 facilities across the U.S. into the 1950s, when the FDA

> closed them down. Hoxsey's head nurse, Mildred , R.N., then

> established the Tijuana clinic to carry on his work. Ms. , who at

> first believed Hoxsey was a fraud, became an advocate of his treatment

> after her mother recovered from advanced untreatable uterine cancer using

> his tonic.

>

> The Livingston Foundation Medical Center, San Diego, Calif.

>

> Subjects were 193 new patients treated for cancer during the first quarter

> of 1992. All records were available for these patients, and pathology was

> confirmed for 78.8 percent. Survival at five years was determined for 94.8

> percent; 14.5 percent of the study group were living and 80.3 percent

> deceased.

>

> The Livingston Center was established in 1969 to offer an immune-based

> treatment developed by Virginia Livingston-Wheeler, M.D. Dr. Wheeler, who

> believed cancer is associated with the Progenitor cryptocides bacteria,

> treated the disease with vaccines she developed to enhance natural

> immunity, supplemented with the Bacille Calmette-Guerin (BCG) vaccine and

> a multifaceted regimen including a vegetarian diet, vitamins,

> antioxidants, detoxification, nutritional counseling, and support groups

> or individual counseling.

>

> The Authors

>

> Lead author Ann , Dr.Ph., is a program officer with the

> National Center for Complementary & Alternative Medicine at the National

> Institutes of Health, Bethesda, MD.. C. , M.P.H., is with the

> Department of Symptom Control & Palliative Care at the University of Texas

> M. D. Cancer Center in Houston. Tina , M.S., is affiliated

> with the Center for Health Promotion, Research & Development of the

> University of Texas--Houston Health Science Center School of Public

> Health, Houston. Barrett, Ph.D., was formerly executive director of

> the Livingston Foundation Medical Center in San Diego, one of the clinics

> studied. Salveson, R.N., Ph.D., is an assistant professor in the

> School of Nursing at Oregon Health Sciences University in Portland.

>

> The Journal of Alternative and Complementary Medicine This peer-reviewed

> international journal provides rigorous scrutiny by respected medical

> professionals in the rapidly growing field of alternative and

> complementary medicine. Its goals are to facilitate more effective

> communication and reliable measurement, data collection and analysis for

> the benefit of patients and practitioners in healthcare systems worldwide;

> to explore research methodologies and results; and to stimulate inquiry,

> dialogue, and discovery. It is indexed in Index Medicus/MEDLINE and

> EMBASE/Excerpta Medica. Editor in chief is Kim A. Jobst, D.M., M.R.C.P.,

> M.F.Hom., and executive editor is Jackie Wootton, M.Ed.

>

> Ann Liebert, Inc., is a publishing firm known for establishing the

> first peer-reviewed journals in the most promising areas of biomedical

> research, including AIDS Research and Human Retroviruses and Human Gene

> Therapy. The company's biotechnology periodical, Genetic Engineering News

> (GEN), was the first in its field and is today the industry's most widely

> read publication worldwide. A complete list of Liebert's 60 publications

> is available at www.liebertpub.com.

> ------------------------------------------------------------------------

> Contact:

>

> Ann Liebert, Inc., Larchmont

> Joanne Gallichio, 914/834-3100, ext. 629

> jgallichio@...

>

>