BMJ  2007;335:952 (10 November), doi:10.1136/bmj.39388.456065.1F

Letters

What to do about CAM?

Evidence is important but should not be the only consideration: patients' and clinicians' views matter too

The first 150 words of the full text of this article appear below.

Health systems need to use resources to their maximum effect. This naturally leads them towards evidence based medicine, since those interventions that have been shown in well conducted (randomised) studies to be most effective should usually be prioritised over those where high quality evidence is lacking.

Problems arise where systems have to juggle alternative choices where the evidence is lacking or weak, or the benefits/harms trade off is marginal. The figures quoted by Garrow (previous letter) from BMJ Clinical Evidence are correct, but they provide an overly pessimistic picture of the state of evidence for orthodox medicine, since interventions in complementary and alternative medicine (CAM) and other non-orthodox treatments are included and are over-represented in the "unknown" category. Contrary to Garrow's implication, however, where multiple well conducted studies have shown no effect BMJ Clinical Evidence would categorise these interventions as "unlikely to be beneficial" rather than "unknown effectiveness." None the . . . [Full text of this article]

BMJ Knowledge, BMJ Group, London WC1H 9JR

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