Patel M S
Soc Sci Med. 1987;24(2):169-75. doi: 10.1016/0277-9536(87)90249-8.
As an increasingly informed public becomes more and more disillusioned with the failure of scientific medicine to live up to its promises and to fulfill popular expectations, attention has been turning to 'holistic,' 'traditional,' 'alternative' or 'complementary' medicine. Forms of medical treatment such as acupuncture, homeopathy, and ayurvedic medicine have infrequently been rigorously evaluated. This paper reviews the traditional structures of clinical and economic evaluation of health care, and then describes a particular set of specific problems that would be encountered in applying these techniques to 'holistic' medicine under the headings 'reductionism' (bias from excluding certain categories of effects), 'taxonomic difficulties' (problems inherent in the choice of diagnostic criteria), and the 'logical basis for comparison' (procedural difficulties). Various methods for comparing the results of different schools of medical thought are suggested and evaluated.
随着信息日益灵通的公众对科学医学未能兑现承诺、满足大众期望越来越感到失望，注意力已转向“整体”“传统”“替代”或“补充”医学。针灸、顺势疗法和阿育吠陀医学等医疗形式很少经过严格评估。本文回顾了医疗保健临床和经济评估的传统结构，然后描述了在将这些技术应用于“整体”医学时会遇到的一组特定问题，这些问题分别在“还原论”（排除某些类别的影响所产生的偏差）、“分类困难”（诊断标准选择中固有的问题）以及“比较的逻辑基础”（程序困难）等标题下进行阐述。文中还提出并评估了比较不同医学思想流派结果的各种方法。
