Talk:Alternative medicine

Characterization

The "characterization" section looks very good, at least in principle. One problem: under the section headed by "Scientific community", "institutions" are given far less space than "scientists", even though it is widely accepted on WP that institutions are superior sources for scientific topics (see, e.g., WP:MEDRS). By word count, "institutions" receives 100 words and "scientists" receives 546. More specifically, Stephen Barrett (most of whose work is self-published without indications of peer review) alone gets 110 words, more than the entire "Institutions" section; the Institute of Medicine, one of the best English-language sources for the life sciences, gets only 26 words. One might justify that state of affairs by arguing that Barrett and others have published a great deal more than some of the scientific bodies cited: the NSF, for example, devotes only 7-8 paragraphs to CAM in a paper discussing science fiction and pseudoscience. The IOM, however, published a 360-page book, Complementary and Alternative Medicine in the United States. (Barrett has criticized the IOM book, but his criticisms depend on CAM being held to a different set of ethical standards of research than biomedicine, and if anything, his reasoning, tone and self-publication show how far he has diverged from mainstream discourse.)

Yes, sometimes we do need to rely on less than wonderful sources (like Barrett) as "balancing" sources when few sources other than promoters of a given CAM exist. But for characterization of CAM itself, we have an extremely high-quality source in the IOM, one that is superior to any individual scientist publishing via peer review, let alone scientists who self-publish and eschew the peer review process. Yet this source is given extremely short shrift. Therefore, we have a major undue weight problem as things currently stand. Does anyone disagree? regards, Middle 8 (talk) 01:27, 3 June 2010 (UTC)

Would you like to propose some wording from the IOM? That might be a good place to start. -- Brangifer (talk) 02:26, 3 June 2010 (UTC)

Sure; in a nutshell, I'd expand the "Institutions" section and prune the "Scientists" so they were, at a minimum, 50:50. I'm pretty busy IRL so am not in a rush. Just wanted to get a sense here of how other editors feel about the general idea before proceeding. regards, Middle 8 (talk) 04:59, 3 June 2010 (UTC)

Expansion...yes. Pruning....no. This edit drastically reduced the size of the article and changed its format. I can hardly recognize it anymore. -- Brangifer (talk) 06:02, 3 June 2010 (UTC)

@Brangifer: Wow, that's some diff. I take it you don't necessarily consider it an improvement, but there was adequate consensus for it? Don't worry, I won't delete anything. In this case, adding sounds better. --Middle 8 (talk) 03:49, 7 June 2010 (UTC)

Exactly. If I haven't been involved in a discussion of such a change, I usually don't revert, as long as there has been adequate discussion. I feel the old format was good and conveyed the sense of reality.....that there is much discussion and not full agreement. I hope that didn't get lost in that huge edit. It was so huge that I can't figure it out and I don't like headaches! -- Brangifer (talk) 14:13, 7 June 2010 (UTC)

I agree with BR. Expand don't delete. Verbal chat 06:22, 3 June 2010 (UTC)

complementary?

uf, I see talk pages here are huge, could there be a FAQ page, made by editors which have been involved in this article for a longer time? I see the issue was debated many times, but getting to the gist of the argument seems fairly time consuming if it means digging through archived conversations. I'm simply wondering if either the article or title or both might reflect the opinion of some who consider complementary and alternative medicine quite distinct - for instance, Prof. Michael Baum Interview from "The Enemies of Reason." , or at least the uncut version of it available at Richard Dawkins Foundation channel - where he takes 'alternative' to mean basically unproven alleged remedies, and complementary only to actually proven medicine that 'complements' traditional treatments - he worked with art therapies, and proven herbal remedies, though its not clear to me what he actually means by 'complementing'.. Aryah (talk) 20:19, 27 June 2010 (UTC)

Integrative Medicine is NOT the same as "Alternative" medicine. I really think it should have its own page and not be redirected. Integrative Medicine is the use of western/ allopathic medicine in combination with other non-conventional yet *evidenced based* treatment modalities. It differs from the old termenology "CAM - Complementary and Alternative Medicine" because of the strictly controlled research component -- in other words, only using treatments that have been researched and shown to be as effective as other treatments (i.e. the use of acupuncture for chemotherapy induced nausea and vomiting. See reference at http://www.annualreviews.org/doi/abs/10.1146/annurev.med.51.1.49?journalCode=med) This is why Harvard, Yale, Columbia, Hopkins, UCLA, UCSF and all other big name MED schools have an Integrative Medicine dept., NOT a "Complementary and Alternative Medicine" department. —Preceding unsigned comment added by Berkeley19 (talk • contribs) 05:48, 3 December 2010 (UTC)

Efficacy of complementary medicine in children

The evidence-base for complementary medicine in children: a critical overview of systematic reviews. Reference for article. QuackGuru (talk) 03:33, 6 September 2010 (UTC)

Levity

If editors here need a break, I'd suggest today's episode of [The Irrelevant Show], which has a nice bit on "alternative crime". Enjoy. LeadSongDog come howl! 21:15, 27 November 2010 (UTC)

Appeal

This section may warrant a bit of cleanup, especially the second through fourth paragraphs. For one thing, there are six citations of an article from The Scientific Review of Alternative Medicine, which appears to serve as the Center for Inquiry's anti-CAM editorial page. Compounding the potentially POV tone, the statements taken from these 'speculations' begin to be worded like facts. For instance:

"There is also an increase in conspiracy theories towards conventional medicine and pharmaceutical companies..."

On that subject, I believe the term 'conspiracy theories' might be a bit weighted. Perhaps some expansion with references cited on these pages would be helpful.

http://en.wikipedia.org/wiki/Pharmaceutical_industry#Controversy_about_drug_development_and_testing http://en.wikipedia.org/wiki/Pharmaceutical_industry#Controversy_about_drug_marketing_and_lobbying http://en.wikipedia.org/wiki/Criticism_of_the_Food_and_Drug_Administration

Apologies if this has been discussed. Any thoughts? AveVeritas (talk) 14:29, 1 January 2011 (UTC)

Merge from Integrative medicine

There is a new page at Integrative medicine that is mostly redundant with Alternative medicine but contains a bit of content that should be merged here. We just had a discussion last month (note that the page histories have been swapped) indicating a continued consensus that this topic is best treated at a single page. The original merge discussion a few years back gave a strong consensus for this, but it is possible that consensus has changed. In any event, that page needs a strong WP:MEDRS and WP:NPOV filter applied to it. - 2/0 (cont.) 20:31, 18 February 2011 (UTC)

• Support merge. CLear WP:CONTENTFORK - Most alternative medicines employ science based medicine to at least some extent; the separate category of "integrative medicine" is just another euphamism like "alternative medicine" was initially supposed to be, to replace "quackery". PPdd (talk) 00:29, 19 February 2011 (UTC)

• At this time (though I can always be convinced), I strongly oppose such a merger. Certainly, this article needs improvement, as virtually any article of such length and depth would require within two weeks of its creation, and many good suggestions on how to do so were just given in the peer review, but I don't see how you can reasonably claim that this article only contains 2-3 paragraphs of useful content. There's a lot of non-promotional material here that is backed by citations to reliable sources. Where content is overly promotional or biased, it should, of course, be improved, but I don't see how that constitutes grounds for scrapping the whole thing.

Furthermore, it seems clear to me that there is a non-trivial distinction between Alternative medicine and Integrative medicine. Alternative medicine is defined by the NIH as "the broad range of healing philosophies, approaches, and therapies that mainstream Western (conventional) medicine does not commonly use, accept, study, understand, or make available." In contrast, integrative medicine, as I understand it from this article and UCSF's definition, emphasizes the evidence-based combination of conventional and alternative medicine along with better integration in the health care delivery system in terms of the patient-practitioner relationship and collaboration of care between practitioners in different specialties. Where the scope of the article Alternative medicine is any sort of healing practice that doesn't fall into Western medicine, the scope of the article Conventional medicine is far more limited and distinct, covering specifically the use of clinically tested practices in concert with conventional medicine, and also discussing the healthcare delivery topics that are certainly out of scope in Alternative medicine. The topics are, of course, related, and a "see also" hatnote is appropriate to connect the articles, but I see a large enough distinction here for integrative medicine to support its own article. Also, several major US medical schools (Harvard and UCSF to name two) have established large programs for research and practice in integrative medicine. Surely that merits some consideration from a notability perspective?

Finally, I want to say that I have no particular dog in this fight, and really am not particularly knowledgeable in the subject, minus the research I've done after this article appeared. I found the article while reviewing submissions at WP:AfC and was struck by its depth and breadth of sources, especially as the vast majority of new articles I see are well within the criteria for speedy deletion. As such, I became interested in improving this article. Thus far, I have focused primarily on stylistic issues and copy editing, but sought the peer review precisely on how to get feedback on how to better focus this article and address the promotional material. I would rather do that process in collaboration with other editors, especially editors with greater knowledge of the field than go through the usual drama of debating whether to preserve useful content on Wikipedia. Zachlipton (talk) 01:03, 19 February 2011 (UTC)

• Comment - Zachlipton, what additional material could there be in an integrative medicine article that should not already be in the alternative medicine article (which includes an integrative medicine section)? PPdd (talk) 02:45, 19 February 2011 (UTC)

Well, just brainstorming and looking through the existing Integrative medicine article, here are some such topics that integrative medicine focuses on that are generally not emphasized in contemporary Western medicine, many of which might be presented in summary style with a "main article" link to other articles: stress reduction/biofeedback techniques (yoga, meditation, etc...), Psychoneuroimmunology, health coaching, environmental medicine, patient centered care, the use of integrated teams of specialists to coordinate care (Disease management (health)), interdisciplinary health research, integrative approaches to pain management (combining pharmacology with other techniques), health psychology and behavioral changes, health education, workplace health improvement initiatives, overall wellness promotion, and preventative medicine. In addition, an integrative medicine article could discuss the history of the term and movement, its connections to and distinctions from alternative medicine, major institutions and research organizations (e.g. the Osher centers), and fellowships and training programs in integrative medicine. That seems like a fairly deep article to me, not 2-3 paragraphs.

Integrative medicine seems to be about more than just alternative medicine. For instance, according to the summary section of the report of the Institute of Medicine Summit on Integrative Medicine, "care coordination that emphasizes wellness and prevention" is "a hallmark of integrative medicine." And I don't simply mean coordination between the doctor and an acupuncturist, this is discussed in the context of transitions like those "from hospital to home care." This page from the summary (the report states it was prepared by independent rapporteurs of the IOM as an summary of the views expressed at the Summit) lists some of the major areas participants viewed as part of integrative medicine. Alternative medicine is a relatively small part. Now, one might well say that the topic of integrative medicine is simply too broad and/or vague and it's more of a fancy term for "practice good medicine and make/keep people healthy," but the main focus seems to be on integrating different parts of the entire health and wellness field to best serve patient needs as an alternative to the uncoordinated "find-it-and-fix-it mentality" (IOM Summary pg. 11) common in Western symptom-diagnosis-treatment medicine.

It is clear that integrative medicine's supporters, rightly or wrongly, are establishing it as a distinct academic field separate from alternative medicine as they have moved away from Andrew Weil and related advocates. This can be seen by the establishment of integrative medicine programs at Harvard, UCSF, Duke, Scripps and Sloan-Kettering, among others. I don't want to promote quackery and I think the article needs to be honest and frank about both the good and bad in integrative medicine. In particular, I think it needs to focus primarily on rigorous reviews and not individual study results, and I don't doubt there are a number of alternative medicine quacks who desire to legitimize their fields through the label of integrative medicine, but that's a separate issue from the question of merger. Going back to the definitions, integrative medicine is a style of medicine and area of clinical research that includes, among other things, evidence-based alternative medicine. Alternative medicine is simply all healing practices outside of conventional medicine. The former is a philosophy of medicine and area of academic research, while the latter is a catch-all collection of stuff. Zachlipton (talk) 05:15, 19 February 2011 (UTC)

Thanks for the good faith thinking. But all of the example you cite are example of specialized fields of science based medicine. If you take any specialized group of fields in science based medicine, you could say that science based medicine does not focus on them. For example, my girlfriend at stanford was a psychologist doing your first example, psychoimmunology. She was doing science based medicine, and would scoff at the suggestion that it was "integrative". Or cancer research, which "integrates" environmental, diet, etc. medicines. Certainly cancer research should not be put under the heading of integrative medicine. Heart disease research similarly focuses on overall lifestyle, and integrates diet, excercise, psychological stress, the environment, etc. But this is not "integrative medicine". The hallmark of integrative madicine is that it implements alternative medicine, hence the label "quackademic medicine", now a standard term in most university medical schools. PPdd (talk) 21:53, 20 February 2011 (UTC)

• Support merge. There has been no significant change of the definition of "integrative medicine" since our last decision to merge the two. Integrative medicine is basically a definition of how alternative medicine methods are used in a mainstream medical setting by those physicias who choose to use such techniques and methods. The techniques are exactly the same, it is only the setting that is changed. The definition can easily be incorporated here and take up no more than a paragraph. If it is deemed necessary to enlarge it to 2-3 paragraphs in its own section, that can also be done here. -- Brangifer (talk) 02:19, 19 February 2011 (UTC)

Comment - I just started an integrative medicine section in alt med, and also a simple subsection for criticism unique to integrative medicine as distinct from alternative medicine. PPdd (talk) 02:47, 19 February 2011 (UTC)

I like having a section on history of the term integrative medicine (to go wherever the Weil material ends up), but I think academic alternative medicine is really just part of the story of the growth in popularity of alternative medicine. For instance, someone donating $37M to a hospital to build a center for integrative oncology is not really the same as a school of chiropractic trying to merge with a medical school. - 2/0 (cont.) 04:10, 19 February 2011 (UTC)

I started a history subsection (but did a very poor job, I just copied the two RS sentences from the IM article). PPdd (talk) 19:10, 21 February 2011 (UTC)

• Copyvio alert - the original was closely paraphrased from [1]; the source and its sources might be usable after checking, but I will be gutting the copied material if the article has been edited too much to qualify for speedy. If anyone is merging material from that article to this one, please check it against that link or reword it from your sources. - 2/0 (cont.) 05:54, 19 February 2011 (UTC)

Your tagging Integrative medicine for speedy deletion as a copyvio really doesn't seem to advance the discussion process here. CSD G12 is only for "unambiguous copyright infringement," but certainly the vast majority of the Integrative medicine article bears no resemblance to the page you linked. I see some copying in the "Cost Effectiveness" section, which is a very small portion of the article. Surely you could have followed standard procedure and just blanked the relevant content and posted a notice? In any case, the authors of that document appear to dedicate most of their content to the public domain (I did not know this, but just found this on google), which would avoid the issue entirely (though text should obviously be properly attributed anywhere it's not and NPOV ensured). I'd rather discuss the issue here instead of trying to delete the entire article. Zachlipton (talk) 06:04, 19 February 2011 (UTC)

• Support merge. II | (t - c) 19:51, 19 February 2011 (UTC)

• Strongly oppose It would make much more sense to include alt med in integrative med, but I don't expect to see that happen. Thus I believe it should have its own article as it is quite a separate entity. Integrative med stresses a holistic approach to health care. It urges the patient to use the approach that best helps to promote healing. Generally that means mainstream medical approaches, but often complementary practices (and less frequently even alternative methods) are advised as well. Just this morning, watching the "Today" show on TV, they interviewed an individual from an Integrative Medicine group to refute the latest miracle cancer cure. Our local TV evening shows (Portland, Maine) frequently interview individuals involved in complementary medicine - and they don't snicker either. I sometimes feel that the small group that controls this article is stuck in the past while the rest of the world is moving forward. Gandydancer (talk) 21:33, 20 February 2011 (UTC)

Comment - Gandydancer, please cite an example of information that would be in the integrative medicine article, which is not or should not be in the alternative medicine article.Also, science based medicine also stresses on a holistic approach, such as stress reduction, diet, and health recommendations, so what exactly would be in the integrative medince article that is not covered in the alternative medicine article, beyond alternative medthods used, or used to supplement, science based medicine? PPdd (talk) 21:42, 20 February 2011 (UTC)

I think the "stress reduction, diet, exercise" (and maybe call in your priest/minister/rabi/medicine man also) is something medicine pays lip service to, mostly without the kind of strong level I or II evidence required by the EBM approach. Worse still, when a "kitchen sink" of stuff works (think the Ornish program) "science-based medicine" has no way of telling which parts of it were the essential parts, or if there was some synergistic effect. For example, can you leave out the meditation part of the Ornish program, or not? Where is the placebo-controlled study of the benefits of meditation, or for that matter, of exercise? (And how did you do that study??) The thing about EBM is that it contains a lot of separated-out stuff that we have very good evidence for, and then there's ALSO a whole lot of stuff that makes sense that we really don't have good Level I EBM evidence for (but have some evidence as parts of programs or epidemiologically), and that level II stuff and even some level III, is what we add in and now call IM or "integrative medicine" (which is a lot of EBM level I, II, III plus social work and psychiatry, which is to say, the average practice of traditional medicine as it's usually done, not as Dr. House on TV would do it). Alternative medicine tends to leave any anything EBM I or II, and to be a grab bag of specific techniques, some of which are used in IM, and others of which would never even get to EBM level III because nobody believes in them mechanistically (crystal healing, energy healing, homeopathy, etc). Perhaps even chiropractic and acupuncture, which would have been in IM 20 years ago, but which are now starting to drift toward alternative stuff that EBM-lovers don't consider as worthy candidates for an IM approach (especially if they take the place of things we consider have more chance of doing mechanistic good). This is a spectrum of stuff in which it is hard to draw lines. Not surprisingly, because it involves induction, and thus it's all the set of continuous probabilities, from good to bad. Place your bets. SBHarris 00:19, 21 February 2011 (UTC)

• Strongly Oppose. It is clear that Integrative Medicine, while potentially involving alternative medicine, is not at all reliant on it. Based on my understanding, an integrative treatment plan could potentially include only non-alternative medicine, depending on the individual. Putting Integrative medicine under Alternative Medicine would be similar to merging an article on common sources of dietary protein into the meat article.129.10.188.176 (talk) 13:11, 22 February 2011 (UTC)

• Comment. That's nonsensical. The very definition makes it clear that it is alternative medicine (AM) techniques and methods that are being "integrated". You can't just make up definitions or change them. The whole basis for the existence of IM is to legitimize the use of AM in mainstream medical settings. The wording of IM's definition is deceptive, since if it's proven, it's no longer "alternative" but "medicine". To make matters worse, in practice almost any method, no matter how ridiculous or disproven, is being used in so-called "integrated" settings and the quacks who run them claim they are practicing IM or CM. Considering that the main source of the IM idea is a user of mind altering drugs, what can one expect other than muddled thinking? -- Brangifer (talk) 16:49, 22 February 2011 (UTC)

• Strongly Oppose. Alternative medicine should be a subsection of Integrative Medicine and not the other way around. As defined by the National Center for Complementary and Alternative Medicine at the National Institutes of Health, integrative medicine "combines mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness."(SLSQK (talk) 18:50, 22 February 2011 (UTC))

Removed "Rationalization" section as it was entirely uncited; science-based medicine

At this point on Wikipedia, we don't really accept new edits without sources, especially in controversial areas where there could be a lot of disagreement. So I removed the new section, which was recently added by User:PPdd. The section had an obviously rather negative spin on alternative medicine, which is OK but it needs to be sourced and also probably balanced by a rebuttal per WP:NPOV. Ideally, we have an academic source which doesn't seem to be on a crusade but is rather documenting facts.

I noticed that the section used the phrase "science based medicine", as contrasted with alternative medicine. This type of comparison needs to be sourced. I would prefer that we try to avoid this term, which is rarely used in sources, and rather stick with the more standard term of mainstream medicine or conventional medicine, or perhaps if appropriate evidence-based medicine. Science-based medicine is associated with a small group of bloggers over at the website Science-based medicine. While they have a lot of good articles, they also have quite a few bad ones and tend to lean very traditional and pro-industry (ie, use a lot of drugs, don't worry much about side-effects, drug companies don't really distort research, xenobiotic chemical exposures are nothing to be concerned about, etc) - for example, when their founder Steve Novella decided to look into Bisphenol A, he just invited a chemist from the industry trade group to give a podcast lecture without any counter view, which is somewhat representative of the group's approach to questions. It's not a reliable source and we shouldn't be discreetly plugging them. II | (t - c) 19:30, 21 February 2011 (UTC)

No problem, I should have RSd it before putting it in. Re pro-industry POV, I was invited to lecture at MIT on neuroethics by, of all departments, one of the chemical engineering department's biochem industry fundees. After they had already flown me out, they found out about my self-funded studies on psychopharaceutical abuse and indirect refunding of the industry by MIT funding pill pushing psyciatrists, and I was summarily disinvited. But Science Based Medicine's has information sourcing in addition to their blogging, and it is very reliable. I have yet to find an error that was not immediately retracted, and very few erros in the first place, as the information in its non-blog information section is peer reviewed by a team of expert editors. PPdd (talk) 21:04, 21 February 2011 (UTC)

Alt Med journals revisited - Application of MEDRS re biomed conclusions "peer reviewed" by alt med and pseudoscience journals

Alt Med journals revisited: Application of MEDRS re biomed conclusions "peer reviewed" by alt med and pseudoscience journals - Application of MEDRS re biomed conclusions "peer reviewed" by out of field non-experts is being discussed here[2]. PPdd (talk) 16:05, 22 February 2011 (UTC)