Complementary and alternative medicine encompasses a host of different therapies. To understand them, it helps to dissect the terminology.
- Conventional medicine (sometimes called Western medicine) refers to treatments that a medical doctor (MD or DO) is likely to prescribe. This is considered “mainstream medicine” and is the most widely used form of medical treatment in the US health care system.
- Complementary medicine is a treatment or therapy used in combination with conventional medicine. For example, massage, guided imagery, and acupuncture may be used in addition to analgesic medications to decrease pain.
- Alternative medicine is a treatment given in place of a conventional one; for example, some adolescents use herbs rather than antidepressant medication to treat depression.
Taken together, complementary and alternative medicine, or CAM, represents a large and diverse group of health care systems, practices, and products that are based on philosophies and techniques other than those used in conventional medicine. Health care professionals who practice integrative medicine use a combination of conventional and complementary treatments to treat their patients.
Randomized, Controlled Clinical Trial (RCT)
When it comes to treating disease, conventional medicine relies primarily on biomedicine, which is based on the laws of science and the use of the scientific method for evidence. Most treatments are biomedical and based on research, in particular a model known as the randomized, controlled clinical trial (RCT).
In an RCT, some subjects are given a treatment and others are not, but the researchers do not know who receives the treatment and who doesn’t. The research is typically published in a peer-reviewed academic journal. This means it’s been closely scrutinized by a panel of medical experts, peers of the researchers who practice in the field that is being studied. The peer-review process is designed to maintain professional, ethical, and scientific standards and provide credibility to the study. In addition, peer review determines if an academic study is suitable for publication in a peer-reviewed journal or other publication.
Many alternative remedies have not undergone such rigorous scrutiny. Instead, support for these treatments is often anecdotal, meaning it’s based on casual observations or a story about a person or a situation. This evidence is not as reliable as that from an RCT. All cases or anecdotes are not represented, and anecdotal data are difficult to verify as being an accurate representation of the situation. Sometimes an individual response is inappropriately generalized for all people. The scientific method cannot be used in most cases to investigate anecdotal data. The scientific method uses careful written observation and collection of measurable data to answer questions through carefully designed experiments. Anecdotal data can become a testimonial to help promote a product or an idea.
Just because an alternative treatment has not been subjected to an RCT does not mean it will not work. It’s possible, too, that some alternative remedies may benefit from the placebo effect, in which the patient’s faith in the treatment—or the practitioner delivering it—may be enough to bring about a positive effect.
CAM for Children with Autism Spectrum Disorders (ASDs)
For any parent considering a CAM treatment for a child with an ASD, the most important thing you can do is to become educated and use common sense. Know the potential benefits of the treatments and understand the risks involved. Your pediatrician can help you in this process, and together you can decide whether or not to pursue the treatment. See table below. It’s also important to know the resources needed to start and maintain the therapy. Many of these therapies can be quite costly.
It is important for parents to investigate if a CAM therapy has been researched in an evidence-based scientific study. You can often find these studies on university or national accredited Web sites such as the National Institutes of Health (www.ncbi.nlm.nih.gov/pubmed).
A Commonsense Guide to Complementary and Alternative Medicine Treatment Recommendations
From Kemper K, Cohen M. Ethics meet complementary and alternative medicine: new light on old principles. Contemp Pediatr. 2004;21:65
|Is the therapy safe?
||Monitor closely or discourage