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Yes, if it embraces standardization and conventional research tools
Two years ago, the editors of the New England Journal of Medicine declared : "It is time for the scientific community to stop giving alternative medicine a free ride." 1 Here were the voices of orthodoxy, loud and clear, sounding the death knell of complementary and alternative medicine (CAM). Echoing a long history of medical tribalism, 2 CAM was once again under attack for being antiscientific and grounded in unproven narrative.
Since that declaration, CAM practitioners and researchers have tried to defend their practices. They have begun to publish in peer-reviewed biomedical journals, and they recently held an international congress addressing research methodology and quality management. 3 A CochraneCollaboration will publish a series of papers critically appraising systematic reviews of 30 CAM therapies. 4 All this, despite minimal research funding or infrastructure.
So, is the argument now over ? Not quite, for there are still two fundamental conflicts between the "art" of CAM and the"science" of evidence-based medicine. Resolving these conflicts is the key to distinguishing evidence-based complementary medicine from practices based on anecdote.
The first conflict is between standardization and individualization.Evidence-based medicine emphasizes reproducibility. It attempts to define a universal "best practice," based on large randomized controlled trials and meta analyses. This is the antithesis of CAM, which focuses on the individual interaction between patient and practitioner. Within the personal framework of CAM, no two interactions can ever be the same. Its practitioners argue that the consultation, a complex interplay between two people, is itself therapeutic, and it necessarily defies empiric understanding. Using a randomized controlled trial to measure CAM would be analogous, with this argument, to measuring a delicate rose with a ruler.
But this stance is no longer acceptable. A physician faced with a patient who has a particular disease manifestation needs to know precisely which orthodox or complementary treatment will help. The problem with CAM to date has been that...