Examination of Witnesses (Questions 540-543
PROFESSOR JONATHAN
BROSTOFF, MS
KATE CHATFIELD,
PROFESSOR CHRIS
CORRIGAN AND
PROFESSOR EDZARD
ERNST
21 FEBRUARY 2007
Q540 Viscount Simon: I would like to
go back, if I may, to what Professor Corrigan was describing,
the equipment for Vega testing. If someone went along and was
Vega tested and the result was X, would the result be the same
X if they went along to someone else half an hour later?
Professor Corrigan: No. There have been well
designed studies around this issue. This is one of the few useless
tests that has been conclusively proven useless by very well performed
trials in which various practitioners were asked to analyse the
same patients and came up with answers which differed no more
from random. I think one can safely say that no is the answer.
Q541 Chairman: I wonder if I could ask
you all a question in relation to research and research evidence
that we have heard often is not there and whether the outcome
measures that are being used to assess these different modalities
have possibly been the wrong outcome measures? How much have quality
of life assessments been incorporated and how have the domains
in those quality of life assessments been evolved and validated?
Professor Ernst: This is a question about any
patient centred outcome measure. In the past, medicine has been
accused of measuring what is measurable rather than what is relevant.
That has dramatically changed. We have, if anything, too many
quality of life measurements rather than too few these days. Any
good trial these days must include a measure of quality of life
both in mainstream and in complementary medicine. In complementary
medicine, it has largely been adopted so I do not know of any
reasonably good trial that totally neglects the patient's view
in that sense.
Ms Chatfield: I would agree with that in the
main. Things have improved a great deal recently in respect of
how people are looking at the various outcome measures and how
we can improve them and make them more suitable to the testing
of the outcome that we want to measure, of course. With the kind
of holistic treatment that we are measuring in homeopathy, we
still do not have an outcome measure that successfully can measure
the effect on every level. By their very nature, randomised control
trials are trying to measure very specifically. Homeopathy is
going to affect the whole person. It is very difficult to measure
an outcome for a whole person.
Q542 Chairman: I wonder if any of the
work that was done in the cancer field such as in Sequoia, which
is a very personalised quality of life measure, has been used
in assessing any of these?
Ms Chatfield: It would be if we had the money
to carry out the trials. We would be looking at all of those things.
Professor Corrigan: There are well designed
quality of life measures for asthma and rhinitis which are used
in conventional, clinical trials but sadly not in trials of homeopathy,
for example.
Ms Chatfield: They are.
Professor Corrigan: I have just picked one at
random from this year's homeopathy where this doctor has treated
147 asthmatics and claimed that all but two of them got better,
based on his personal observation and no objective measurements
whatsoever.
Ms Chatfield: That is one paper. I would disagree
there.[5]
Q543 Chairman: One of my questions
relates to the overall usage and if you have any figures on how
many patients are using complementary and alternative medicine,
amongst the population with the different allergies. We know in
the cancer field about 50 per cent of patients who are undergoing
conventional cancer treatments are also using some form of complementary
or alternative medicine. Indeed some, such as reflexology and
aromatherapy, are provided within the NHS setting. I wonder if
you have any comments on that in relation to patients with asthma?
Professor Corrigan: Yes I do. Interestingly,
there is a recent paper by Slader and colleagues, three Australian
physicians, who address this very question: Complementary and
alternative medicine in asthma: who is using what? They estimate
that 59 per cent of adolescents and children are using complementary
alternative medicines and somewhat fewer adults, but less than
10 per cent of them make it known to their general practitioners
without general or specific questioning. So probably thousands
of people in the UK with asthma are using them.
Professor Ernst: According to our own publication
which we conducted with the National Asthma Campaign in this country,
and which dates back now about seven years, it is around a third
of British patients who use complementary therapies. I would not
want anybody however to over-estimate these surveys because they
are fraught with lots of difficulties. For instance, depending
on how you define any of these umbrella terms like "complementary
medicine" you can generate any prevalence figure. If I remind
you that drinking tea is a herbal remedy, strictly speaking, then
all of us use complementary medicines.
Chairman: On that note, could I thank
you for coming. If there is additional information that you would
like to submit to us as a Committee, I would invite you to do
so following this session and it will be considered as part of
the evidence that you have given today. I would be grateful, Professor
Corrigan, if we could have a copy of the paper that you referred
to in the last couple of minutes. Thank you very much.
5 Generally today researchers in any form of complementary
medicine have to strive harder to ensure validity and reliability
of their methods than their counterparts in conventional medical
research. It is more difficult for them to get research ethical
approval, to get funding and to get published. Extreme bias can
mean that their work is scrutinised to a high level. Even the
authors of the Lancet meta-analysis that was so damning of homeopathy
concluded that the homeopathy trials were of better quality than
the comparison trials of conventional medicine. Back
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