Dr. Andrew Weil, among the best-known medical doctors practicing alternative and complementary medicine, suggests researchers are ignoring an important endpoint when they evaluate the success or failure of clinical drug trials: how the patient feels about the treatment.
Weil, a longtime leader in alternative -- or integrative -- medicine, is best known today for his books, blog and various products. It’s been awhile since he ventured into the serious business of scientific research and medical practice. But in a commentary published Thursday, Weil and two co-authors speak out on drug trials and propose a revised rating scale for evaluating a treatment’s effectiveness.
Medicine has become enslaved to “evidence-based” approaches that rely on randomized, clinical trials as the only measure of whether a treatment is valuable, Weil and his co-authors wrote. While these gold-standard studies are vital, they are not the only way to measure worth, they said.
When evaluating a study’s outcome, researchers should consider the funding source, study design and other factors, Weil and his co-authors proposed. Safety issues should warrant a separate, detailed grading scale that would heighten their importance. Patient factors - including how patients felt about the treatment, whether they can afford it and any evidence of a placebo response - should be recognized as a crucial factor in a treatment’s potential value. Even an ecological rating could be applied to research that addresses whether the treatment would have any detrimental environmental impact (such as contributing to antibiotic resistance).
“Every treatment may have rankings of safety and effectiveness but there is no right or wrong in medical decision-making without considering the specific needs of the individual patient,” the authors wrote. “The individual’s belief system will affect the value of a treatment significantly and cannot be ignored.”
The paper is intended to help doctors overcome the “significant, artificial, and philosophically driven divide between complementary and alternative medicine and conventional care,” as the they authors describe it. However, the big-picture question about whether the age-old format for evaluating of medical research needs an overhaul is worthy of discussion.
Many medical doctors disparage integrative medicine and have no use for Andrew Weil. But he and his co-authors raise some terrific questions about how well the current system of evaluating new drugs is working for those it’s meant to serve: patients.
The paper is published in the journal Alternative and Complementary Therapies.
Return to Booster Shots blog.