More than onethird of Americans use complementary or alternative medicine (CAM). The vast majority of patients use CAM in addition to, rather than instead of, a conventional medical regimen.

With more and more conversations about CAM taking place at the point of care, “The ACP EvidenceBased Guide to Complementary & Alternative Medicine” is a welcome resource for clinicians and patients.

“The book is a comprehensive analysis of CAM treatments that busy clinicians can use to incorporate evidencebased information into pointofcare discussions with patients,” said coeditor Katherine Gundling, MD, FACP.

Organized according to medical condition, “The ACP EvidenceBased Guide to Complementary & Alternative Medicine” focuses on the safety and efficacy of a full range of CAM therapies, providing “ataglance” answers to the questions clinicians are often asked.

“Patients tend to seek help from clinicians before starting a CAM therapy,” said Bradly P. Jacobs, MD, MPH, a coeditor of the book. “This gives clinicians an opportunity to play a vital role in discussing the range of treatment options available, both conventional and CAM, based on the evidence for safety and effectiveness, cost, personal preferences, and individual circumstances.”

To ensure that readers have quickaccess to bottomline recommendations after indepth reviews of the research, every chapter includes tables that are concise and easy to read.

Chapter 1 addresses basic questions such as “What is CAM?”, “Which patients are using CAM?”, “What is the terminology that might be unfamiliar to doctors?”, and “How does one evaluate evidence for CAM treatments?” Chapter 2 hones in on the practical implications of CAM in the office “How can clinicians approach this topic with competence and caring?” Even beyond direct patient interaction, there are legal, insurance, and regulatory issues that demand attention, and these are addressed in this chapter as well.

Chapters 3 to 15 cover the common conditions that characterize most patientclinician interactions. Although patients might ask about an entire system of practice (”Would Traditional Chinese medicine help?”), or a specific treatment (”Does Echinacea help colds?”), most frequently these questions are asked in the context of a particular health concern (”What will help my osteoarthritis?”). This problembased approach focuses on the immediate concern of the patient and whether complementary therapies can be of benefit or cause harm.

The editors incorporate a stateoftheart approach toward evaluating the quality of evidence for CAM therapies based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group, a system endorsed by the American College of Physicians, the U.S. Department of Health and Human Services Agency for Healthcare and Research Quality (AHRQ), the World Health Organization, and others.

Testimonials

“Finally, we have a comprehensive, evidencebased textbook that clinicians can rely on when counseling their patients about complementary and alternative medical therapies. Indepth reviews of the research are thoroughly digested into concise summary tables, placing key information at the readers fingertips. This book is perfect for the busy healthcare professional who needs a practical and evidencebased guide to CAM practices. No doubt, it will be used time and time again in your daily clinical practice.”
Brian Berman, MD, Professor and Founding Director for the Center for Integrative Medicine, University of Maryland School of Medicine

“A practical, well researched summary that will help integrate unconventional healing approaches into the mainstream healthcare system.”
Mehmet Oz, MD, Vice Chair and Professor of Surgery, NY Presbyterian Hospital, Columbia University

“This edition provides a valuable and indeed essential compendium of a broad range of CAM therapies and evidence of their efficacy and safety, or lack thereof, for different clinical applications. It includes practical recommendations that the busy clinician can use in considering the responsible use of CAM therapies as part of a comprehensive approach toward patient care.”
Ralph Snyderman, MD, Chancellor Emeritus, Duke University

“This book is a mustread for healthcare professionals interested in using an evidencebased approach toward integrating alternative therapies into clinical practice. Drawing on exhaustive research reviews, the authors present their material in an easytoread format, including summary tables in each chapter with bottomline recommendations organized by treatment and condition. I believe this book will be of great help to busy healthcare professionals who need scientifically sound guidance about CAM practices.”
Andrew Weil, MD, Director, Arizona Center for Integrative Medicine, University of Arizona

About the Editors

Bradly Jacobs, MD, MPH, is Founding Medical Director, Matowih Center for Health Living, Sausalito, California; and Attending Physician, Veterans Affairs Medical Center, San Francisco, California.

Katherine Gundling, MD, FACP, is Associate Clinical Professor of Allergy and Immunology, Department of Medicine, University of CaliforniaSan Francisco.

Source
American College of Physicians

Health and religion have always been intertwined, most obviously through prayer on behalf of the sick. Does intercessory prayer for sick people actually help heal them? For thousands of years some people have believed so. But new Brandeis University research in the Journal of Religion this month shows that over the last four decades, medical studies of intercessory prayer the prayer of strangers at a distance actually say more about the scientists conducting the studies than about the power of prayer to heal.

Intercessory prayer has been the subject of scientific study since at least the nineteenth century, when an English scientist, assuming that kings were prayed for more often than others, sought to find out whether those prayers were answered. He concluded that they were not, but that prayer might be a comfort to the people praying anyway.

After talking with physicians who wondered about the power of prayer to heal patients, Brandeis sociologist Wendy Cadge, an expert on the intersection of religion and medicine in contemporary American society, set out to research medical studies of intercessory prayer going back to 1965, the first year such studies were published in the English language medical literature.

“This analysis in the Journal of Religion is the first to trace the social history of intercessory prayer studies and to situate them in their medical and religious contexts,” said Cadge, who this year is the Suzanne Young Murray Fellow at the Radcliffe Institute for Advanced Study at Harvard University. While there she is working on her forthcoming book, Paging God Religion in the Halls of Medicine.

Cadge evaluated eighteen published studies on intercessory prayer that were conducted between 1965 and 2006. Collectively, the studies provide a fascinating snapshot of changing American religious demographics, evolving ideas about the relationship between religion and medical science, and the development of the clinical trial as the gold standard of biomedical research, said Cadge.

“I do not know why physicians and scientists conducted these studies,” said Cadge, “but personal religious beliefs appear to have played a role, along with curiosity.”

The earliest studies undertaken in the sixties were based exclusively on Protestant prayers, while more recent studies, reflecting growing social awareness of other religions, combine Christian, Jewish, Buddhist and other prayers, Cadge discovered. Some studies suggested that prayer worked, while others said it didnt.

The researchers leading the studies applied clinical scientific methodologies to the study of intercessory prayer, but Cadge found that even that approach was fraught with problems. For example, researchers asked whether the people not being prayed for by the intercessors were truly a control group, since their family members were probably praying for them. Researchers also asked what the right “dosage” of prayer would be, how prayers should be offered, and what to do about nonChristian intercessors.

“With double blind clinical trials, scientists tried their best to study something that may be beyond their best tools,” said Cadge, “and reflects more about them and their assumptions than about whether prayer works.”

Reflecting a recent shift toward delegitimizing studies of intercessory prayer, recent commentators in the medical literature concluded “We do not need science to validate our spiritual beliefs, as we would never use faith to validate our scientific data.”

Source
Laura Gardner