scholarly journals Scientific framework of homeopathy: evidence-based homeopathy

2021 ◽  
Vol 7 (23) ◽  
pp. 72-92
Author(s):  
Michel Van Wassenhoven
Keyword(s):  
Scientific Evidence ◽  
Daily Practice ◽  
Evidence Based ◽  
Review Of Literature ◽  
High Dilution ◽  
Randomized Controlled ◽  
Palabras Clave ◽  
Meta Analyses ◽  
Based Medicine ◽  
Scientific Framework

This paper aims at considering all important aspects of the scientific framework of homeopathic practice, looking at the levels of scientific evidence of each aspect in an objective way, through an extensive review of literature. Levels of evidence considered are: I) existence of meta-analyses and/or systematic positive reviews of literature; IIa) multiple positive randomized controlled trials (RCTs); IIb) some positive RCTs; IIIa) positive multiple cohorts studies; IIIb) positive studies with some cohorts; IV) opinion of experts (clinical and daily practice cases). Conclusions are clear: homeopathy must stay within the framework of medical practice, and it is even a necessity for public health. Keywords: Evidence-Based medicine, Homeopathy, Scientific framework, Literature review.   Marco científico da homeopatia: homeopatia baseada em evidéncias Resumo O presente artigo aborda aspectos importantes do marco científico da prática homeopática, focando os níveis de evidéncia de cada um deles de maneira objetica, através de uma revisão extensa da literatura. Os níveis de evidéncia considerados são: I) existéncia de meta-análises e/ou revisões sistemáticas positivas da literatura; IIa) múltiplos estudos randomizados controlados (RCTs) positivos; IIb) alguns RCTs positivos; IIIa) estudos de coortes múltiplas positivos; IIIb) estudos com algumas coortes positivos; IV) opinião de expertos (casos clínicos da prática cotidiana). As conclusões são claras: a homeopatia deve permanecer dentro do marco da prática médica, sendo, inclusive, uma necessidade para a saúde pública. Palavras-chave: Medicina Baseada em Evidéncias, Homeopatia, Estrutura ciéntifica, Revisão de literatura.   Marco científico de la homeopatía: homeopatía basada en evidencia Resumen Este artículo aborda aspectos importantes del marco científico de la práctica homeopática, enfocando los niveles de evidencia de cada aspecto, de modo objetivo, mediante una revisión extensiva de la literatura. Los niveles de evidencia considerados son: I) existencia de meta-análisis y/o revisiones sistemáticas positivas de la literatura; IIa) múltiples ensayos randomizados controlados (RCTs) positivos; IIb) algunos RCTs positivos; IIIa) estudios con cohortes múltiplas positivos; IIIb) estudios con algunas cohortes positivos; IV) opinión de expertos (casos clínicos de la práctica cotidiana). Las conclusiones son claras: la homeopatía debe permanecer dentro del marco de la práctica médica, siendo, inclusive, una necesidad para la salud pública. Palabras-clave: Medicina enbasada en evidencia, homeopatía, estructura científica, Revisión de la literatura.   Correspondence author: Michel van Wassenhoven, [email protected] How to cite this article: Wassenhoven MV. Scientific framework of homeopathy: Evidence-based Homeopathy. Int J High Dilution Res [online]. 2008 [cited YYYY Mmm DD]; 7(23): 72-92. Available from: http://journal.giri-society.org/index.php/ijhdr/article/view/286/354.  

Otorhinolaryngology

2016 ◽  
Keyword(s):  
Primary Care ◽  
Randomized Controlled Trials ◽  
General Practitioners ◽  
Individual Patient Data ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
The Past ◽  
Meta Analyses ◽  
Based Medicine

Conditions of the ear, nose, or throat (ENT) are common diagnoses in primary care and are a frequent indication for referral to secondary care. They have a major impact on health and health-care resources, and it is therefore important that the management of ENT conditions is based upon the best available evidence. Such evidence should come from methodologically sound research in patients representative of those seen in everyday practice. Over the past decades, general practitioners and ENT surgeons have embraced the principles of evidence-based medicine, actively contributing to randomized controlled trials in this field. Consequently, management of ENT conditions is shifting from experience-based to evidence-based. The randomized controlled trials and individual patient data meta-analyses presented in this chapter have been instrumental in the development of clinical guidelines that allow general practitioners and ENT surgeons to make evidence-based shared decisions for the management of some of the commonest ENT conditions.

scholarly journals A guide to do randomized controlled trials in the field of otolaryngology

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Sameh M. Zamzam ◽  
Mosaad Abdel-Aziz ◽  
Ahmed Atef ◽  
Usama Abdel-Naseer ◽  
Mostafa Hamoda ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Study Groups ◽  
Controlled Trials ◽  
Main Body ◽  
Main Research ◽  
Randomized Controlled ◽  
New Treatment ◽  
Meta Analyses ◽  
Based Medicine

Abstract Background Randomized controlled trials (RCTs) are prospective comparative studies in which study groups are allocated randomly to intervention or serve as controls. RCT is the mainstay to achieve evidence in the literature in clinical research. A RCT is the main research design to study the effect of an intervention and the only way to confirm the value of a new treatment. Main body RCT also gives the way to generate meta-analyses and systematic reviews giving a stronger evidence for clinical practice. Evidence-based medicine (EBM) is crucial for safe, effective, and standardized patient care. Although there is an agreement on the importance of performing RCT, it can be challenging to do it efficiently including different aspects like study design, funding, randomization, blinding, follow-up, data analysis, statistics, generalization of results, and reporting of quality of the studies. Conclusion In this article, we gave a comprehensive review for RCT in otolaryngology discussing their importance, advantages, and drawbacks, types, steps, challenges, reporting their quality and their prevalence in the literature.

scholarly journals Evidence-Based Medicine in judicial decisions concerning right to healthcare

2016 ◽  
Vol 14 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Eduardo Rocha Dias ◽  
Geraldo Bezerra da Silva Junior
Keyword(s):  
Health Insurance ◽  
Evidence Based Medicine ◽  
Private Health Insurance ◽  
Scientific Evidence ◽  
Federal Court ◽  
Public Healthcare ◽  
Evidence Based ◽  
Unified Health System ◽  
The Individual ◽  
Based Medicine

ABSTRACT Objective To analyze, from the examination of decisions issued by Brazilian courts, how Evidence-Based Medicine was applied and if it led to well-founded decisions, searching the best scientific knowledge. Methods The decisions made by the Federal Courts were searched, with no time limits, at the website of the Federal Court Council, using the expression “Evidence-Based Medicine”. With regard to decisions issued by the court of the State of São Paulo, the search was done at the webpage and applying the same terms and criterion as to time. Next, a qualitative analysis of the decisions was conducted for each action, to verify if the patient/plaintiff’s situation, as well as the efficacy or inefficacy of treatments or drugs addressed in existing protocols were considered before the court granted the provision claimed by the plaintiff. Results In less than one-third of the decisions there was an appropriate discussion about efficacy of the procedure sought in court, in comparison to other procedures available in clinical guidelines adopted by the Brazilian Unified Health System (Sistema Único de Saúde) or by private health insurance plans, considering the individual situation. The majority of the decisions involved private health insurance plans (n=13, 68%). Conclusion The number of decisions that did consider scientific evidence and the peculiarities of each patient was a concern. Further discussion on Evidence-Based Medicine in judgments involving public healthcare are required.

scholarly journals Revisiting Statistics and Evidence-Based Medicine: On the Fallacy of the Effect Size Based on Correlation and Misconception of Contingency Tables

2021 ◽  
Author(s):  
Sergey Roussakow
Keyword(s):  
Effect Size ◽  
Evidence Based Medicine ◽  
Binary Data ◽  
Contingency Tables ◽  
Evidence Based ◽  
Mean Square ◽  
Bias Analysis ◽  
Contingency Coefficient ◽  
Meta Analyses ◽  
Based Medicine

Abstract BACKGROUND: Evidence-based medicine (EBM) is in crisis, in part due to bad methods, which are understood as misuse of statistics that is considered correct in itself. The correctness of the basic statistics related to the effect size (ES) based on correlation (CBES) was questioned. METHODS: Monte Carlo simulation of two paired binary samples, mathematical analysis, conceptual analysis, bias analysis. RESULTS: Actual effect size and CBES are not related. CBES is a fallacy based on misunderstanding of correlation and ES and confusion with 2 × 2 tables that makes no distinction between gross crosstabs (GCTs) and contingency tables (CTs). This leads to misapplication of Pearson’s Phi, designed for CTs, to GCTs and confusion of the resulting gross Pearson Phi, or mean-square effect half-size, with the implied Pearson mean square contingency coefficient. Generalizing this binary fallacy to continuous data and the correlation in general (Pearson’s r) resulted in flawed equations directly expressing ES in terms of the correlation coefficient, which is impossible without including covariance, so these equations and the whole CBES concept are fundamentally wrong. misconception of contingency tables (MCT) is a series of related misconceptions due to confusion with 2 × 2 tables and misapplication of related statistics. Problems arising from these fallacies are discussed and the necessary changes to the corpus of statistics are proposed resolving the problem of correlation and ES in paired binary data. CONCLUSIONS: Two related common misconceptions in statistics have been exposed, CBES and MCT. The misconceptions are threatening because most of the findings from contingency tables, including meta-analyses, can be misleading. Since exposing these fallacies casts doubt on the reliability of the statistical foundations of EBM in general, we urgently need to revise them.

scholarly journals Breast Cancer Research to Support Evidence-Based Medicine in Nigeria: A Review of the Literature

2021 ◽  
pp. 384-390
Author(s):  
Omolara A. Fatiregun ◽  
Temiloluwa Oluokun ◽  
Nwamaka N. Lasebikan ◽  
Emmanuella Nwachukwu ◽  
Abiola A. Ibraheem ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Research ◽  
Randomized Controlled Trials ◽  
Evidence Based Medicine ◽  
Treatment Guidelines ◽  
Breast Cancer Research ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Based Medicine

PURPOSE Breast cancer is the most common malignancy in women worldwide. In Nigeria, it accounts for 22.7% of all new cancer cases among women. Evidence-based medicine (EBM) entails using the results from healthcare research to enhance the clinical decision-making process and develop evidence-based treatment guidelines. Level 1 and 2 studies, such as randomized controlled trials, meta-analyses, and systematic reviews of randomized controlled trials, yield more robust types of evidence. This study reviewed the levels of evidence of breast cancer publications in Nigeria. METHODS We conducted an electronic literature search of all studies published on breast cancer in Nigeria from January 1961 to August 2019. We reviewed all the articles found under the search term “Breast Cancer in Nigeria” on medical databases. RESULTS Our search identified 2,242 publications. One thousand two hundred fifty duplicates were removed, and 520 were excluded. A total of 472 articles were considered eligible for this review. Most of these articles were case series or reports (30.7%), qualitative studies (15.7%), followed by cross-sectional studies (13.3%), laboratory studies (12.9%), case-control studies (6.1%), case reports (7%), and cohort (5.7%). CONCLUSION Breast cancer research in Nigeria is yet to produce much evidence of the types considered to best support EBM. The scarcity of data hampers the implementation of EBM in Nigeria. Currently, most treatment guidelines are adapted from those developed in other countries, despite genetic differences among populations and different environmental influencing factors.

scholarly journals THERAPEUTIC METHODS IN CEREBRAL PALSY FROM THE STANDPOINT OF EVIDENCE-BASED MEDICINE

2019 ◽  
Vol 21 (3) ◽  
pp. 168-174
Author(s):  
Leila A. Pak ◽  
K. V. Zherdev ◽  
L. M. Kuzenkova ◽  
A. L. Kurenkov ◽  
B. I. Bursagova
Keyword(s):  
Cerebral Palsy ◽  
Stem Cell ◽  
Evidence Based Medicine ◽  
Vagal Stimulation ◽  
Clinical Manifestations ◽  
Evidence Based ◽  
Complementary Treatment ◽  
Epidural Stimulation ◽  
Meta Analyses ◽  
Based Medicine

In the article the authors consider such methods of the alternative/complementary treatment of the cerebral palsy (CP), presented in the modern domestic and foreign literature, as metabolic (amino acid composites), metamer (I.A. Skvortsov), intravenous administration of baclofen, antiepileptic (vagal stimulation, levetiracetam), acupuncture, transcranial cerebral micropolarization, epidural stimulation, modified motion-induced restriction therapy (MMIRT), stem cell therapy, as well as some other complementary/palliative approaches to the correction of clinical manifestations of various forms of CP. The final part of the article presents the attitude of modern evidence-based medicine to the main methods of the alternative/complementary treatment of cerebral palsy. These data are based almost exclusively on international systematic reviews and relevant meta-analyses.

Unhealthy Politics

2020 ◽  
Author(s):  
Eric M. Patashnik ◽  
Alan S. Gerber ◽  
Conor M. Dowling
Keyword(s):  
United States ◽  
Health Care ◽  
Scientific Evidence ◽  
The United States ◽  
Evidence Base ◽  
Medical Industry ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Delivery Of Medical Care ◽  
Based Medicine

The U.S. medical system is touted as the most advanced in the world, yet many common treatments are not based on sound science. This book sheds new light on why the government's response to this troubling situation has been so inadequate, and why efforts to improve the evidence base of U.S. medicine continue to cause so much political controversy. The book paints a portrait of a medical industry with vast influence over which procedures and treatments get adopted, and a public burdened by the rising costs of health care yet fearful of going against “doctor's orders.” It offers vital insights into the limits of science, expertise, and professionalism in American politics. The book explains why evidence-based medicine is important. First, the delivery of unproven care can expose patients to serious risks. Second, the slow integration of evidence can lead to suboptimal outcomes for patients who receive treatments that work less well for their conditions than alternatives. Third, the failure to implement evidence-based practices encourages wasteful spending, causing the health care system to underperform relative to its level of investment. This book assesses whether the delivery of medical care in the United States is evidence based. It argues that by systematically ignoring scientific evidence (or the lack thereof), the United States is substantially out of balance.

How to Search and Critique Scientific Evidence for Decision-Making

2017 ◽  
pp. 100-123
Author(s):  
Mayuree Tangkiatkumjai ◽  
Win Winit-Watjana ◽  
Li-Chia Chen
Keyword(s):  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Literature Search ◽  
Scientific Evidence ◽  
Clinical Decision ◽  
Evidence Based ◽  
Search Terms ◽  
Based Medicine ◽  
Complementary And Alternative

A clinical decision on the use of complementary and alternative medicine (CAM) should be made based on evidence-based medicine (EBM) together with practitioner's knowledge and experiences. This chapter describes the process of EBM, including how to address a clinical question, do a systematic search for appropriate evidence with key search terms, appraise the evidence and make a clinical decision on CAM applications. An effective literature search should be performed by using a structured search strategy in searching biomedical and CAM databases, such as the National Center for Complementary and Alternative Medicine (CAM Citation Index). Few standard tools are recommended to evaluate the quality of CAM studies, i.e. the CONSORT extension for herbal interventions and STRICTA for RCTs of acupuncture. Additionally, some guidelines for designing RCTs in Chinese herbal medicine (CHM) can also be adopted to critique CAM literature. A clinical decision on choosing optimal CAM for patient care should be based on the current best evidence emerged from the EBM process.

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