© 1999 Evidence-Based Mental Health
EBMH notebook
Evidence-based medicine and complementary medicine
Integrative Medicine Service, Memorial Sloane-Kettering Cancer Center, New York, NY, USA
To apply evidence-based medicine (EBM) to complementary medicine (CM)—treatments such as acupuncture, chiropractic, homeopathy, or herbal medicine—seems, at first glance, a contradiction in terms. CM is often defined as techniques for which no evidence of benefit exists (or as a speaker at a recent Cochrane Colloquium put it, "medicine is either scientific or complementary"). But many of the interventions used by conventional clinicians have little scientific support; conversely, there is evidence from randomised trials in support of some interventions that are commonly described as CM. CM is an increasingly prevalent aspect of health care: about 10% of the UK population visit a practitioner each year,1 and about 40% of UK general practices offer their patients access to CM services on the national health service.2 As such, CM constitutes important area for the implementation of EBM for better patient care.
There are two perspectives for thinking about EBM and CM. The
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