New Treatment Options: Knowing What to Use

One of the main reasons that I created this blog is that I want to empower you: I want to give to give you the information that you need to care for yourself and the people around you.

One of the problems with many new treatments is that they promise the earth, sometimes drag people away from things that may help them and then fail to deliver.

This is something that I struggled with in the field of holistic medicine for thirty years. I constantly hear and see fantastic claims that cannot be right and are often based on a complete misunderstanding of how the body functions. On the other hand there are some highly unorthodox methods and techniques that can be amazingly helpful. My job has been to find out which is which!

But it is not only in the field of unorthodox medicine. I have recently heard about something very questionable in the field of psychotherapy. Somebody has invented a new form of therapy that cuts across and ignores decades of research. He is now offering certifications in his method. So long as you have a very basic healthcare qualification, you pay him a few hundred dollars, do an online training and then you can set up shop as a therapist. Many members of the public do not know how little regulation there is for some of these therapies.

Here are some guidelines for checking out a new therapy or remedy:

1. Efficacy
Be suspicious of any treatment or therapist if they:

• Claim that a treatment works for everyone: I have yet to find ANY treatment that works for everyone
• Only use case histories or testimonials as proof. The plural of anecdote id not evidence. If we see or hear about something that looks promising, it is essential to confirm the reports with systematic, independent controlled research. Be aware that if that has not been done, the person selling you the treatment or the therapist claiming to help is essentially experimenting on you. And if they want to experiment they need your consent and the approval of an Institutional Review Board. And don’t buy into the “my work is so brilliant and cutting edge that nobody will publish it in a journal.” It is hard to publish really new work, but we cannot believe what people are saying until it has been subjected to peer review: other experts go through the work with a fine toothcomb to see if it is right.
• Cite only one study as proof. Hundreds of promising studies have turned out to be dead ends when someone else tried to repeat it. You can be a lot more confident if several studies have shown the same thing.
• Cites a study that did not have a control (comparison) group. That is always a first step in evaluating a new treatment.
• Cite a study that you cannot see yourself. We spend a lot of time checking some of the claims made on infomercials and websites. They often talk about some obscure study in a hard-to-find journal written in a foreign language. We go and find the papers and if necessary translate them. We constantly find that the studies quoted contain results that are 180 degrees away from what they claim.
• Only reference themselves. This recently came to light with a form of therapy that comes with a short book. There was not one scientific citation, but loads of self-references, so it looked as if there was something credible behind it.
• Testing a treatment without a control group is a necessary first step in investigating a new treatment, but subsequent studies with appropriate control groups are needed to clearly establish the effectiveness of the intervention.

2. Safety?
Be wary if:

• A therapist or someone promoting a remedy cannot tell you the exact consequences of not following up with some other treatment. Safety is not only about the safety of a product or a therapy: it is also about the risks of declining a proven treatment
• A therapist tells you stop any other treatment that you are on without discussing the risks of stopping it, and without discussing the situation with any previous therapist. It does not matter whether you were on a medication or having acupuncture. Different treatments interact, and stopping and starting can be risky. If a therapist who does not prescribe medications tells you stop them, be very, very careful. There are precise ways to discontinue most treatments
• A remedy comes without precise directions about how to use it
• Something does not list its contents or ingredients
• A product has no information or warnings about side effects
• If a product or therapeutic approach is described as natural, with the implication that natural means safe. Hurricanes, arsenic and deadly nightshade are all natural!

3. Promotion
Be very cautious if a therapy or treatment:

• Claims to be based on a secret formula or a secret that has been deliberately hidden from you
• Claims that the particular treatment or therapy is being suppressed or unfairly attacked by the medical or therapeutic communities
• Claims to work immediately and permanently for everyone
• Is described as an “Amazing breakthrough” or a “Miracle.”
• Claims to be a cure for something that other experts believe is incurable. They could be right, but then we have to go back to the first point about efficacy
• Is only promoted through infomercials, self-promoting books, online or by mail order

4. Evaluating Media Reports

• When evaluating reports of health care options, consider the following questions:
• What is the source of the information? Good sources of information include medical schools, government agencies (such as the National Institutes of Health and the National Institute of Mental Health), professional medical associations, and national disorder/disease-specific organizations. Information from studies in reputable, peer-reviewed medical journals is more credible than popular media reports.
• Who is the authority? The affiliations and relevant credentials of “experts” should be provided, though initials behind a name do not always mean that the person is an authority. Reputable medical journals now require researchers to reveal possible conflicts of interest, such as when a researcher conducting a study also owns a company marketing the treatment being studied or has any other potential conflict of interest.
• Who funded the research? It may be important to also know who funded a particular research project.
• Is the finding preliminary or confirmed? Unfortunately, a preliminary finding is often reported in the media as a “breakthrough” result. An “interesting preliminary finding” is a more realistic appraisal of what often appears in headlines as an “exciting new breakthrough.” You should track results over time and seek out the original source, such as a professional scientific publication, to get a fuller understanding of the research findings

5. What Are the Financial Implications of This New Therapy or Remedy?

• Is the treatment covered by health insurance?
• What out-of-pocket financial obligation will you or your family have?
• How long will this out-of-pocket financial obligation be?
• Is there any kind of guarantee?
  

Tips for Finding Reliable Information Online
The good news is that the Internet is becoming an excellent source of medical information. The bad news is that with its low cost and global entry, the Web is also home to a great deal of unreliable health information.
In addition to the tips cited earlier, Web surfing really needs some special considerations:
Know the source. The domain name tells you the source of information on the Web site, and the last part of the domain name tells you about the source. For example:
.edu = university/educational
.biz/.com = company/commercial
.org = non-profit organization
.gov = government agency

The same rules do not always apply if you are looking at websites in other countries.
Obtain a “second opinion” regarding information on the Web. Pick a key phrase or name and run it through a search engine to find other discussions of the topic or talk to your health care professional.

Experts who spend time and trouble evaluating reports and then publish their findings online will often answer questions. RichardGPettyMD.blogs.com is one that does, and there are many others.