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This Week in JAMA
November 11, 1998

This Week in JAMA

JAMA. 1998;280(18):1551. doi:10.1001/jama.280.18.1551
Alternative Medicine Theme Issue

Edited by Phil B. Fontanarosa, MD, and George D. Lundberg, MD

One year ago, the editors of JAMA and the AMA Archives Journals selected alternative medicine as the topic for their annual coordinated theme issues. This month, these 10 journals present more than 80 articles on a wide range of topics in alternative medicine.

Use of Alternative Therapies Increases in the US

Results of a nationwide survey indicate a marked increase in the number of individuals using alternative therapies between 1990 and 1997. Eisenberg and colleagues report that most use of alternative therapies is not supervised by either physicians or alternative therapy practitioners, and estimate total out-of-pocket expenditures for alternative therapies at $27 billion.

See Article

Scientific Scrutiny Applied to Alternative Medicine

This issue of JAMA features 6 randomized trials of alternative therapies for common clinical problems.

Bove and NilssonArticle found that patients with episodic tension-type headaches treated with chiropractic spinal manipulation or an active control had similar reductions in daily headache hours and analgesic use.

Cardini and WeixinArticle report that moxibustion, the application of heat from burning herbs to an acupuncture point, for primigravida women with fetuses in breech presentation at 33 weeks' gestation significantly increased cephalic presentation at 35 weeks' gestation and at birth.

Bensoussan and colleaguesArticle found that patients with irritable bowel syndrome treated with Chinese herbal medicine formulations had significant improvements in symptoms compared with those treated with placebo.

Shlay and colleaguesArticle report that neither a standardized acupuncture regimen nor amitriptyline hydrochloride afforded effective pain relief for patients with HIV-related peripheral neuropathy.

Heymsfield and colleaguesArticle found that losses in body weight and fat mass were no different in overweight patients treated with a high-fiber, low-energy diet and Garcinia cambogia than in those treated with diet and placebo.

Garfinkel and colleaguesArticle report that patients with carpal tunnel syndrome treated with yoga and relaxation techniques had significant improvements in grip strength and pain reduction compared with baseline.

Malpractice and Alternative Medicine

Studdert and colleagues report that between 1990 and 1996 malpractice claims against chiropractors, massage therapists, and acupuncturists occurred less frequently than against physicians and the injuries were less severe.

See Article

No Alternatives for Knowledge and Science

In an editorial critically examining the relationship between alternative medicine and conventional medicine, JonasArticle describes the promise for advancing knowledge about diseases and healing that resides at the interface of these practices. In a related editorial, FontanarosaArticle and Lundberg emphasize that alternative therapies must be evaluated by rigorous empirical testing.

The Cover

"Neither the formulas of the past nor the technology of the present proved to have any effect, beyond, perhaps, a certain reassurance for user and receiver." Johannes de Ketham, Fasciculus Medicinae, 1495, German.

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Medical News & Perspectives

Doings at the Office of Alternative Medicine, what's brewing among proponents of botanicals, and who's queueing for light therapy.

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A Piece of My Mind

"People in the United States are rushing toward alternative therapies. What's going on?" From "Leeches, Spiders, and Astrology: Predilections and Predictions."

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Policy Perspectives

Definitions, cultural aspects, and economic and political factors have limited research on nonallopathic practices.Article

Ethical principles define the professional obligations of physicians in relation to alternative medicine.Article

Complex methodological issues beset randomized controlled trials to evaluate alternative therapies.Article

Progress is being made in the development of a registry of clinical trials and a database of systematic reviews in complementary medicine.Article

JAMA Patient Page

For your patients: A primer on alternative therapies.

See Article