Confessions of a Quackbuster

This blog deals with healthcare consumer protection, and is therefore about quackery, healthfraud, chiropractic, and other forms of so-Called "Alternative" Medicine (sCAM).

Tuesday, January 04, 2005

House of Lords - Science and Technology - Sixth Report

House of Lords

Science and Technology - Sixth Report


Here you can browse the report together with the Proceedings of the Committee. The published report was ordered by the House of Lords to be printed 21 November 2000.

CONTENTS

REPORT

SUMMARY

CHAPTER 1: INTRODUCTION

What is Complementary and Alternative Medicine?

Growing Use of CAM in the United Kingdom

British Surveys


Table 1: Use of CAM in the United Kingdom

United States Surveys

Table 2: Use of CAM in the USA

Reasons for Accessing CAM

Survey Data


Table 3 :Reasons for Using CAM

Other Possible Explanations
Approach of This Report

Conduct of this Inquiry

CHAPTER 2: DISCIPLINES EXAMINED

Definitions of the Various CAM Therapies


Box 1: Short and Simplified Descriptions of CAM Disciplines

Differing Philosophies
CHAPTER 3: PATIENT SATISFACTION, THE ROLE OF THE THERAPIST AND THE PLACEBO RESPONSE

Patient Satisfaction

Patient Dissatisfaction
The Role of the Therapist
Placebo Effect
CHAPTER 4: EVIDENCE

Evidence for Efficacy?

Evidence for Safety

Patient Satisfaction As Evidence For Efficacy

Evidence About Mechanisms of Action
CHAPTER 5: REGULATION

Current Regulatory Status of CAM Professions


Box 2: Status of Some CAM Voluntary Professional Bodies in the United Kingdom.

Box 3 : General Statutory Regulation of CAM

Weaknesses of the Current Situation

Features of an Effective Regulatory System

Box 4: Modern Principles of Statutory Self-Regulation in the Health Field

Regulatory Options

Voluntary Self-Regulation


Box 5: Features of an Effective Voluntary Self-Regulatory Body

Statutory Regulation
Routes To Statutory Regulation

Own Act

Health Act 1999

Box 6 : Criteria for petitioning to come under the Council for Professions Supplementary to Medicine or its successor

Box 7 : Criteria for a Group to be Considered a Profession
Which Therapies Would Benefit From Statutory Regulation?

Acupuncture

Herbal Medicine
Homeopathy
Single Umbrella Regulatory Body?
Regulation of Conventional Healthcare Professionals Practising CAM
Regulation of Herbal Products
CHAPTER 6: PROFESSIONAL TRAINING AND EDUCATION

Standards of CAM Training Courses


Training in Statutorily Regulated CAM Therapies

Training in Non-Statutorily Regulated CAM Therapies

Current Status of Training

General Conclusions
Continuing Professional Development
Validation of Training
What Should CAM Training Courses Include?

Basics of Biomedical Science

Research Methods
Limits of Competence
Familiarisation With Other CAM Therapies
A Core Curriculum?
National Occupational Standards
Training Conventional Medical Practitioners in CAM

Familiarisation for Medical Students


Box 8 : Extracts from Reports of GMC Visits to United Kingdom Medical Schools 1998-99

Postgraduate Familiarisation for Doctors
Training for Medical Practitioners
Nurses, Midwives and Health Visitors

Familiarisation

Training
Conclusion
CHAPTER 7: RESEARCH AND DEVELOPMENT

Priority Areas For Research


Should Specific Therapies be Prioritised?

Research Methods

Randomised Controlled Trials (RCTs)


Box 9: Issues to Consider When Designing RCTs for CAM Therapies

Qualitative Research

Box 10: Some Forms of Qualitative Research: Their Advantages and Disadvantages for CAM Research

Research Outcome Measures
Which Research Method to Use and When
Expertise on Grant-Awarding Boards
Environment and Infrastructure for Research

Research Education

Attracting Mainstream Investigators
Research Funding Sources

The Government


Box 11: Government Funding Options

The Medical Research Charities
Commercial and Industrial Companies
Pump-Priming and Ring-Fencing

The Lessons of NCCAM

Attitude of UK Research Funding Bodies
Co-ordinating the Development of CAM Research
CHAPTER 8: INFORMATION

Information for Healthcare Professionals


The Dissemination of Research Findings

Information for Patients
Media Coverage of CAM
The Internet
Advertising CAM

Table 4: Complaints Against Advertisements

An Overarching Information Body?
CHAPTER 9: DELIVERY

Current Patterns of Delivery

Methods of Delivery

Box 12: Methods of Delivery Within the NHS

Integrated Healthcare

Primary and Secondary Care

Primary Care Groups
Gatekeeper Role of GPs
Criteria for NHS Provision

Figure 1: Factors Affecting PCG Decision Making on CAM Provision

SUMMARY OF RECOMMENDATIONS
APPENDIX 1
Difficulties of Randomised Controlled Trials

APPENDIX 2
Features of the General Osteopathic Council and the General Chiropractic Council

APPENDIX 3
Visit to Mr Simon Mills' CAM Practice, Department of Complementary Medicine, University of Exeter; and the Centre for Complementary Health Studies, University of Exeter On 22/23 March 2000

APPENDIX 4
Visit to the Marylebone Health Centre, 12 April 2000

APPENDIX 5
Visit to the University of Southampton Medical School and the Centre for the Study of Complementary Medicine, Southampton, on 9 June 2000

APPENDIX 6
Special visit to the Glasgow Homeopathic Hospital by two members of the Sub-Committee on 24 August 2000

APPENDIX 7
Sub-Committee 1

APPENDIX 8
List of Witnesses

APPENDIX 9
Acronyms


Note
Written and oral evidence received by the Committee is published in two separate volumes (HL Paper 48 and HL Paper 118).

In the text of the Report:
Q refers to a question in oral evidence;
p refers to a page of written evidence printed in HL Paper 118; and
P refers to a page of written evidence printed in HL Paper 48.

© Parliamentary copyright 2000



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