Hilsden R J, Verhoef M J
Department of Community Health Sciences, University of Calgary, 3330 Hospital Drive N.W., Calgary, AB T2N 4N1 Canada.
Patient Educ Couns. 1999 Oct;38(2):101-8. doi: 10.1016/s0738-3991(99)00057-9.
The use of complementary therapies is common among cancer patients. However, a major concern is that very few of these therapies have been appropriately evaluated and, thus, little is known about their safety and efficacy. The gold standard for evaluating cancer treatments is the randomized controlled trial (RCT). However, there are several issues inherent to the nature and practice of complementary therapies that interfere with the straightforward use of RCTs. Alternative approaches are often highly individualized and attempt to respond to patients' needs. They are often holistic, taking into account many facets of a patient's life. Placebo effects and the role of the provider are frequently recognized as an important part of treatment. Outcomes of complementary therapies are often subjective, rather than being more objective outcomes, such as increased survival time. Although it is important to evaluate complementary therapies, it is mandatory that studies be sensitive to these issues and that existing research methods be adjusted and modified for this purpose.
补充疗法在癌症患者中使用很普遍。然而,一个主要问题是这些疗法中很少有经过适当评估的,因此,人们对其安全性和有效性知之甚少。评估癌症治疗的金标准是随机对照试验(RCT)。然而,补充疗法的性质和实践中存在几个固有问题,干扰了RCT的直接应用。替代疗法通常高度个体化,并试图满足患者的需求。它们往往是整体性的,考虑到患者生活的许多方面。安慰剂效应和治疗提供者的作用常常被认为是治疗的重要组成部分。补充疗法的结果往往是主观的,而不是更客观的结果,如延长生存时间。虽然评估补充疗法很重要,但必须要求研究对这些问题保持敏感,并为此调整和修改现有的研究方法。