Finding research and evidence

A friend of yours may tell you that their arthritis got better after they were treated with a particular complementary therapy. This is good news for your friend and perhaps of interest to you, but you should have more information before you make a decision about which complementary therapy to use for yourself. In this section we give examples of the kinds of information you can look at.

There hasn’t been very much research into complementary medicine in comparison to conventional medicine, but there is an increasing amount of evidence available.

There are a number of ways in which complementary therapies can be tested to see how well they work and different views about which are best. One method is the randomised controlled trial, a clinical trial that is seen as the ‘gold standard’ in research. Many researchers believe that randomised controlled trials produce the most scientific and best quality results. Some complementary therapies have been shown to be helpful when tested in this way.

You might be interested in looking at other kinds of evidence in addition to that from randomised controlled trials. For example, observational studies look at the results of a large group of patients having the same treatment over a period of time and systematic reviews and meta-analyses of clinical trials bring together and analyse the results of previous research. Patient outcome studies are also being accepted as part of the evidence base.

Looking at research may sometimes be confusing, because there is often some that contradicts other research you have already read. Here are details of websites that have information about using research.

• The Best Treatments website, which is run by the publishers of the British Medical Journal, explains how to use research to support your treatment decisions.
• The Research Council for Complementary Medicine has an introduction to research on their website.
• The US National Centre for Complementary and Alternative Medicine has information about clinical trials and complementary medicine.
• Making Sense of Medical Research: An Alternative and Complementary Medicine Resource Guide by the Alternative Medicine Foundation in the USA.
• Informed Health Online, produced by the Health Research and Education Foundation Ltd in Australia has information about research and understanding research.

• Bandolier, located at Oxford University, is a journal and website offering evidence based healthcare information. It specialises in putting information from a range of research sources (including systematic reviews, meta-analyses, randomised trials and observational studies) into simple bullet points. The website is free to search.
• Informed Health Online, produced by the Health Research and Education Foundation Ltd., in Australia, has information for the public about research into complementary medicine.
• MedlinePlus is a website for the public giving health information. It is run by the American National Library of Medicine and National Institutes for Health and includes some information, including safety and research, about complementary medicine including acupuncture, herbal medicine, chiropractic and homeopathy.
• The National Centre for Complementary and Alternative Medicine, in the United States, is a government agency which provides information on its website about complementary medicine and research. The website includes a database, CAM on PubMed, of references to research into complementary medicine.
• The National Library for Health's Specialist Library for Complementary and Alternative Medicine currently has information on Acupuncture, Aromatherapy, Chiropractic, Dietary and Nutritional Therapies, Herbal Medicine, Homeopathy, Hypnosis, Massage, Meditation, Osteopathy, Reflexology and Yoga.
• The Cochrane Collaboration: CAM site includes a glossary of therapies and list of Cochrane reviews on CAM.
• Collected resources on complementary medicine from the BMJ including the ABC of Complementary Medicine series are available for free.

• The Medicines and Healthcare products Regulatory Agency (MHRA)  points out that the standards of production of some unlicensed traditional Chinese herbal remedies vary.  Some have been found to include substances, often undeclared on the label, which could be harmful and are illegal. The MHRA publishes a web page Herbal Safety News which provides information and advice for the public about the safety of herbal medicines and traditional Chinese medicines.
• The National Library for Health's Specialist Library for Complementary and Alternative Medicine is being developed by the  Royal London Homeopathic Hospital, the Research Council for Complementary Medicine, and the School of Integrated Health at the University of Westminster. Although the library is intended primarily for health professionals, CAM practitioners and researchers, much of the information is accessible by the public. Topics currently covered by the library include: Acupuncture, Aromatherapy, Chiropractic, Herbal Medicine, Homeopathy, Hypnosis, Massage, Meditation, Osteopathy, Reflexology and Yoga. In the future other therapies will be included and the library eventually will provide information on a broader range of CAM therapies.
• The Desktop Guide to Complementary and Alternative Medicine, edited by Edzard Ernst contains safety information relevant to most of the complementary therapies included here and about a wide range of herbal and non-herbal medicines.
• The UK Medicines Information website has a section on complementary therapies with fact sheets, including safety information, on some herbal remedies.

NHS Direct Online

NHS Direct Online has some information on acupuncture, chiropractic, osteopathy, homeopathy and safety.

Patients’ experiences

Other patients’ experiences can be a helpful additional source of information. DIPEx.org is a website that includes patients telling you about their experiences of particular illness and treatments. This includes experiences with complementary medicine in relation to cancers, heart disease, mental health and neurological conditions, which are the areas covered by DIPEx at present. There are plans for a number of other topics in the future.

Patient organisations

Some patient support organisations, such as the Parkinson's Disease Society, Breast Cancer Care, and Arthritis Research Campaign, have leaflets about using complementary medicine. You can find details of patient support organisations and self-help groups at www.patient.co.uk.  

You can find organisations that have telephone helplines through the Telephone Helplines Association, which publishes a directory of helplines online.

The information sources we list in this section are reputable and should contain reliable, up-to-date information. If you are looking at other websites, you should be aware that while some information on the internet is reliable, a lot is not.

Quality guidelines

• There are guidelines to help people find and assess health information on the internet. Judge Project has developed guidelines for judging the quality of health web sites.
• DISCERN is a brief questionnaire that can be used to assess the quality of health information. It was originally developed for use with printed consumer health information but it is also useful for information on the internet.
• The Hi Quality website also has guidance to help you check the quality of health information.
• The US website Medline Plus has a guide to looking for health information on the internet.
• The National Center for Complementary and Alternative Medicine in the USA has a list of questions you can ask called 10 Things To Know About Evaluating Medical Resources on the Web.