I recently listened to various speakers addressing the subject of the use of evidence based medicine (EBM) for assessing efficacy of treatment parameters in nutritional and plant based medicine.  In these presentations, various research experts in the field of integrative medicine discussed the latest studies in natural medicine and funding grants along with the pros and pitfalls of using a conventional model of assessment in natural medicine.
The concept of EBM is based on the idea that in a specific controlled environment, one and only one intervention is responsible for producing a positive or negative effect over a given placebo treatment. The results are compiled, peer reviewed, and confounding factors (such as experimenter bias and expectations of participants) are controlled for. Based on how well the design of the model is, sample size, and clinical efficacy, clinicians use these results to adjust their therapeutic protocols.

While, this can be helpful to learn new information and address various disorders, there are a variety of issues when using this model for natural medicine.

Issue 1: Most clinicians don’t find these studies relevant to their clinical practice or review the articles properly to interrupt the results outside of the researcher’s conclusions. Due to this fact, they rely on summaries from drug companies or other biased sources.

Issue 2: Data is usually skewed in favor of the company funding the study (see the last three references below).

The British Medical Journal’s “Clinical Evidence” analyzed common medical treatments to evaluate which are supported by sufficient reliable evidence (BMJ, 2007). They reviewed approximately 2,500 treatments and found: (Note the link to BMJ shows different numbers, actually less favorable, please cross-reference!)

·         13 percent were found to be beneficial

·         23 percent were likely to be beneficial

·         Eight percent were as likely to be harmful as beneficial

·         Six percent were unlikely to be beneficial

·         Four percent were likely to be harmful or ineffective.

·         46 percent were unknown whether they were efficacious or harmful”

 

Issue 3: In real life, people are not in a controlled environment with confounding factors taken out and only using one medication.

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