E Ernst

..Serious adverse events have been reported and further research is required to determine the nature and frequency of such events...

..To evaluate the evidence for and against the effectiveness of homeopathy...

..The German and Austrian medical profession may have forfeited the chance to learn an important lesson relating to its own past...

..However, several uncertainties remain and, at present, prevent unreserved recommendations...

..To summarise recent evidence from case reports (published January 1995-September 2001) of adverse events after cervical spine manipulation...

..It is concluded that good evidence in this area is scarce. Vis-à-vis the high prevalence of unconventional cancer treatments, rigorous investigations are mandatory, not least for increasing the safety of future patients...

..The true prevalence of use of complementary/alternative medicine in the general population remains uncertain...

..The aim of this study was to investigate Internet advice offered by "medical herbalists" to a pregnant woman regarding herbal treatment of morning sickness...

..Asian HMPs are most often implicated. It is concluded that HMPs are not free of risk. More research and more information are required in order to maximize consumers' safety...

..With this high level of prevalence, research into the potential risks and benefits of CM is urgently needed. Dermatologists should consider discussing CM openly with their patients...

..Chelation therapy is popular in the United States. The question of whether it does more good than harm remains controversial...

..Acupuncture is commonly used to treat back pain. A meta-analysis of clinical trials of acupuncture for this condition came to a positive conclusion whilst a qualitative review was negative...

..These findings should alert us to the possibility of heavy metal content in traditional Indian remedies and motivate us to consider means of protecting consumers from such risks...

..It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice...

..However, the majority of the data is anecdotal and insufficient to define prevalence figures. Ways ought to be found to maximize consumer safety...

..Our knowledge regarding the potential benefit and harm of CAM is insufficient...

..The aims of this systematic review are to update the evidence from rigorous clinical trials for or against the efficacy of feverfew for migraine prevention and to provide a safety profile of this herbal remedy...

..The research required to fill the gaps in present knowledge should have a high priority...

..Generally speaking, complementary and alternative medicine is grossly underresearched. Because of the popularity of complementary and alternative medicine, adequately defining risk-benefit relationships is an urgent matter...

..In Germany, for instance, 80% of the Heilpraktiker (nonmedically qualified health practitioners) practice iridology. Ophthalmologists may therefore ask what is iridology and how valuable is it?..

..It would be foolish not to learn from experiences of the past. Nazi medicine can therefore never be an irrelevant subject of the days gone by...

..Sauerbruch are briefly discussed as examples of medical resistance...

..A speedy solution to the obvious problems is therefore not in sight. On the basis of these facts, there are hardly any good reasons for introducing the "Heilpraktiker" in Austria...

..An important argument against spa treatment has been the supposed lack of evidence for its efficacy. This analysis was undertaken to gather firm data bearing on this problem...

..It is concluded that regular exercise for women of practically all ages is well advised...

..On the basis of these findings, a rigorous investigation of the effectiveness, safety and costs of CM in rheumatology seems desirable...

..There is a need for further research involving randomized controlled trials into the efficacy of complementary and alternative therapies in the treatment of depression...

..The efficacy of homeopathic remedies has remained controversial. The homeopathic remedy most frequently studied in placebo-controlled clinical trials is Arnica montana...

..In general, the money spent on CM was modest. It is concluded that CM is frequently used for asthma. Therefore, this area of healthcare would seem to warrant more rigorous investigation...

..None of these herbal medicines is free of adverse effects. Because the evidence is incomplete, risk-benefit assessments are not completely reliable, and much knowledge is still lacking...

..This paper provides a systematic review of adverse drug reactions (ADRs) associated with the use of extracts of the herb St. John's wort (Hypericum perfbratum L.) for the treatment of mild to moderate depression...

..Nonetheless the results of these trials collectively imply that massage therapy could be a promising treatment for chronic constipation. Future, more rigorous trials should evaluate its true value...

..In particular, we should determine the efficacy, safety and expense of these treatments through rigorous, unbiased investigations...

..Under certain conditions, the clinical use of placebos might therefore be a realistic option. In the final analysis, however, our knowledge for a conclusive risk-benefit evaluation of placebo is incomplete...

..Iridologists claim to be able to diagnose medical conditions through abnormalities of pigmentation in the iris. This technique is popular in many countries. Therefore it is relevant to ask whether it is valid...

..Thus location of trials in terms of journal type and impact factor should be taken into account when the literature on complementary therapies is being examined...

..The evidence for this approach is still preliminary but, generally speaking, promising. The challenge for the future is to obtain reliable evidence and to identify those approaches that do more good than harm...

..K., CAM has become a respectable area of scientific investigation only during the last decade. In this article, we review the 10 years of CAM research in Britain...

..The majority of rigorous trial data available to date suggest that ASU is effective for the symptomatic treatment of OA and more research seems warranted. However, the only real long-term trial yielded a largely negative result...

..This trial was aimed at assessing the efficacy of one form of distant healing on common skin warts...

..69; 95% confidence interval, 3.54-15.83). These data imply that kava extract is superior to placebo as a symptomatic treatment for anxiety. Therefore, kava extract is an herbal treatment option for anxiety that is worthy of consideration...

..Many of these apparent responses could have been due to other factors including the use of herbal (non-diluted) Arnica, placebo response and natural course of disease...

..Complementary medicine has become an important aspect of palliative cancer care. This overview is primarily aimed at providing guidance to clinicians regarding some commonly used complementary therapies...

..Numerous pre-clinical and clinical investigations seem to suggest that Ukrain is pharmacologically active and clinically effective. We wanted therefore to critically evaluate the clinical trial data in the form of a systematic review...

..The aim of this article is to compare the evidence relating to the effectiveness of complementary/alternative medicine (CAM) in palliative cancer care as it existed in 2000 and 2005...

..It is concluded that recent clinical trials strengthen the case for hypericum as an antidepressant, but more work needs to be done to answer the remaining questions...

..The reviewed herbal medicines appear relatively safe. CONCLUSIONS: Some herbal medicines may offer a much-needed alternative for patients with osteoarthritis...

..This systematic review evaluates the evidence, from randomised clinical trials (RCTs), for the effectiveness of multiple sessions of classical European (Swedish) MT for the treatment of depression...

..Yet CAM can play an important role in oncology, and that is in supportive and palliative care. Several treatments can decrease the side-effects of cancer drugs or improve quality of life in other ways...

..To evaluate the effectiveness of chiropractic and massage therapy for the reduction of any type of pain...

..It was concluded that a specific effect of face-to-face or distant healing on chronic pain could not be demonstrated over eight treatment sessions in these patients...

..This, in turn, would be to the detriment of future patients. Through discussing the strengths and weaknesses of both sets of arguments, both sides might learn valuable lessons...

..However, the literature indicates that T. wilfordii is associated with serious adverse events which make the risk-benefit analysis for this herb unfavourable. Therefore, we cannot recommend its use...

..On the basis of current evidence, no complementary/alternative therapy can be recommended as a treatment for premenstrual syndrome...

..The aim of this systematic review is to summarise and critically evaluate the evidence for the effectiveness of reiki...

..Considering the popularity of herbal medicine among chronic obstructive pulmonary disease patients, rigorously designed studies seem warranted...

..Anthroposophic medicine (AM) is popular in Europe. This review is an attempt to critically evaluate the effectiveness and safety of AM. The aim is to contribute to a critical discussion of this subject...

..The revised argument should be 'if it helps my patient, I want research undertaken to find out whether more people could benefit from it'...

..The purpose of this systematic review was to evaluate evidence from controlled clinical trials testing the effectiveness of tai chi for osteoporosis...

..Tinnitus is a prevalent condition for which patients may seek treatment with acupuncture since no conventional treatment has been shown to be effective...

..Homeopathy is frequently used to treat asthma in children. In the common classical form of homeopathy, prescriptions are individualised for each patient. There has been no rigorous investigation into this form of treatment for asthma...

..38; 95% CI, 0.14-1.02). These data demonstrate the equality of artemether and quinine for severe malaria and indicate a trend toward greater effectiveness of artemether in regions where there is recognized quinine resistance...

..Large proportions of patients use herbal medicinal products, and encouraging data in terms of effectiveness exist for some of these. One aspect, however, which is still largely under-investigated is the question of potential harm...

..One possible reason for this is that the optimal acupuncture technique was not applied or that the technique was not repeated sufficiently often...

..Herbal medicinal products are often used for the relief of dyspeptic symptoms...

..However, the intake of E. sinica and ephedrine is associated with an increased risk of adverse events. Interventions suggesting positive effects in single RCTs require independent replication...

..The clinical evidence appears promising, however, and more research into this area seems warranted...

..The aim of this study was to investigate whether this representation can be used as a valid method of diagnosis...

..Results also show that patient blinding was successful. In conclusion, this study does not provide evidence that this form of acupuncture is effective in the prevention of episodic tension-type headache...

..It is concluded that adverse effects of herbal medicines are an important albeit neglected subject in dermatology, which deserves further systematic investigation...

..Considering its favourable safety profile acupuncture seems an option worthy of consideration particularly for knee OA. Further studies are required particularly for manual or electro-acupuncture in hip OA...

..The objective of this systematic review and meta-analysis was to assess the evidence for or against the effectiveness of spa therapy and balneotherapy for treating low back pain...

..The clinical relevance of the effect is debatable and the lack of robustness means that the result has to be interpreted with caution...

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..To determine the effectiveness of acupuncture for smoking cessation and to examine whether any individual aspect of trials is associated with an effect...

..CAM journals, and most likely CAM itself, are associated with a lack of clinical trials and a bias in favour of positive conclusions...

..Acupuncture has been suggested as a treatment for stroke rehabilitation, but the question whether it is effective has not been answered satisfactorily...

..Compliance with conventional weight-management programs is notoriously poor, and a plethora of over-the-counter slimming aids are sold with claims of effectiveness...

..To assess the evidence from rigorous clinical trials, systematic reviews, and meta-analyses of complementary and alternative therapies for treating neuropathic and neuralgic pain...

..For reducing blood pressure, few studies are available and the reported effects are too small to be clinically meaningful. For all other conditions not enough data are available for clinical recommendations...

..In conclusion, these results suggest that there is a significant benefit from hawthorn extract as an adjunctive treatment for chronic heart failure...

..The most encouraging data pertain to garlic, autogenic training, biofeedback and yoga. More research is required before firm recommendations can be offered...

..The ones that are documented are usually mild and transient. Combined preparations are more often associated with such events but causal attribution is usually not possible...

..For all other complementary treatment options there is no evidence beyond reasonable doubt to suggest effectiveness for patients with peripheral arterial disease...

..To assess the clinical evidence on the effectiveness of any medical intervention for preventing or treating alcohol hangover...

..Complementary therapies are widely promoted for and used by patients with hepatitis C. The aim is to systematically assess the efficacy of complementary therapies in treating chronic hepatitis C...

..To systematically review all randomized controlled trials (RCTs) on the effectiveness of Ayurvedic medicine for rheumatoid arthritis (RA)...

..Ultimately, we need to know which herbal remedies do more harm than good for which condition. Because of the current popularity of herbal medicine, research in this area should be intensified...

..The use of echinacea products during pregnancy and lactation would appear to be ill-advised in light of the paucity of data in this area...

..The aim of this study was to evaluate the benefit of herbal medicinal products for the treatment of menopausal symptoms by performing a systematic review of randomized clinical trials...

..To systematically review the clinical evidence for herbal medicinal products in the treatment of hypercholesterolemia...

..Although some progress has been made, this field continues to receive too little attention. The future of complementary medicine will depend on whether its modalities can be shown to generate more good than harm for the patient...

..At present, it is impossible to provide reliable incidence figures. It seems important to be vigilant and investigate this area more systematically...

..Flower remedies (also called "Bach" flower remedies) are used by an increasing number of individuals, and many health claims have been made for them. No systematic review of flower remedies has so far been published...

..This is currently the case for only very few such preparations. It follows that, in order to advise consumers responsibly, the gaps in our present knowledge require filling...