A presentation in Turkey about publishing research in complementary and alternative medicines - covers definitions of CAM, RCT registaration, CONSORT, PRISMA

1. Writing and Publishing Scientific
Papers in Complementary
Therapies and Supportive Care
Practices Applications
Roger Watson PhD FAAN
Editor-in-Chief, Journal of Advanced Nursing
27 September 2019

2. Outline
• Overview of CAM
• CAM in Turkey
• Evidence and experiments
• Principles of publishing CAM related articles

4. Definition of CAM
• Complementary and alternative medicine includes practices such as
massage, acupuncture, tai chi, and drinking green tea. Complementary and
alternative medicine (CAM) is the term for medical products and practices
that are not part of standard medical care.
• NATIONAL CANCER INSTITUTE (https://www.cancer.gov/about-
cancer/treatment/cam)

5. Definition of CAM
• Complementary and alternative medicine. Complementary and
alternative medicines (CAMs) are treatments that fall outside of
mainstream healthcare. These medicines and treatments range from
acupuncture and homeopathy, to aromatherapy, meditation and colonic
irrigation.
• NATIONAL HEALTH SERVICE
(https://www.nhs.uk/conditions/complementary-and-alternative-
medicine/)

6. Reiki

7. Acupuncture

8. Moxibustion

9. Osteopathy/Chiropractic

10. Homeopathy

11. THE PRAGMATIC FALLACY
The pragmatic fallacy is committed when one argues that something is true
because it works and where 'works' means something like "I'm satisfied with
it," "I feel better," "I find it beneficial, meaningful, or significant," or "It
explains things for me." For example, many people claim
that astrology works, acupuncture works, chiropractic works, homeopathy wo
rks, numerology works, palmistry works, therapeutic touch works. What
'works' means here is vague and ambiguous. At the least, it means that one
perceives some practical benefit in believing that it is true, despite the fact
that the utility of a belief is independent of its truth-value.

12. THE PRAGMATIC FALLACY
The pragmatic fallacy is committed when one argues that something is true
because it works and where 'works' means something like "I'm satisfied with
it," "I feel better," "I find it beneficial, meaningful, or significant," or "It
explains things for me." For example, many people claim
that astrology works, acupuncture works, chiropractic works, homeopathy wo
rks, numerology works, palmistry works, therapeutic touch works. What
'works' means here is vague and ambiguous. At the least, it means that one
perceives some practical benefit in believing that it is true, despite the fact
that the utility of a belief is independent of its truth-value.

13. THE PRAGMATIC FALLACY
The pragmatic fallacy is committed when one argues that something is true
because it works and where 'works' means something like "I'm satisfied with
it," "I feel better," "I find it beneficial, meaningful, or significant," or "It
explains things for me." For example, many people claim
that astrology works, acupuncture works, chiropractic works, homeopathy wo
rks, numerology works, palmistry works, therapeutic touch works. What
'works' means here is vague and ambiguous. At the least, it means that one
perceives some practical benefit in believing that it is true, despite the fact
that the utility of a belief is independent of its truth-value.

14. THE PRAGMATIC FALLACY
The pragmatic fallacy is common in "alternative" health claims and is often
based on post hoc reasoning. For example, one has a sore back, wears the
new magnetic or takionic belt, finds relief soon afterwards, and declares that
the magic belt caused the pain to go away. How does one know this?
Because it works! There is also some equivocation going on in the alternative
health claims that fall under the heading of "energy medicine," such as
acupuncture and therapeutic touch. The evidence pointed to often uses
'works' in the sense of 'the customer is satisfied' or 'the patient improves,'
but the conclusion drawn is that 'chi was unblocked' or 'energy was
transferred.'

15. THE PRAGMATIC FALLACY
The pragmatic fallacy is common in "alternative" health claims and is often
based on post hoc reasoning. For example, one has a sore back, wears the
new magnetic or takionic belt, finds relief soon afterwards, and declares that
the magic belt caused the pain to go away. How does one know this?
Because it works! There is also some equivocation going on in the alternative
health claims that fall under the heading of "energy medicine," such as
acupuncture and therapeutic touch. The evidence pointed to often uses
'works' in the sense of 'the customer is satisfied' or 'the patient improves,'
but the conclusion drawn is that 'chi was unblocked' or 'energy was
transferred.'

16. THE PRAGMATIC FALLACY
The pragmatic fallacy is common in "alternative" health claims and is often
based on post hoc reasoning. For example, one has a sore back, wears the
new magnetic or takionic belt, finds relief soon afterwards, and declares that
the magic belt caused the pain to go away. How does one know this?
Because it works! There is also some equivocation going on in the alternative
health claims that fall under the heading of "energy medicine," such as
acupuncture and therapeutic touch. The evidence pointed to often uses
'works' in the sense of 'the customer is satisfied' or 'the patient improves,'
but the conclusion drawn is that 'chi was unblocked' or 'energy was
transferred.'

17. THE PRAGMATIC FALLACY
The pragmatic fallacy is common in "alternative" health claims and is often
based on post hoc reasoning. For example, one has a sore back, wears the
new magnetic or takionic belt, finds relief soon afterwards, and declares that
the magic belt caused the pain to go away. How does one know this?
Because it works! There is also some equivocation going on in the alternative
health claims that fall under the heading of "energy medicine," such as
acupuncture and therapeutic touch. The evidence pointed to often uses
'works' in the sense of 'the customer is satisfied' or 'the patient improves,'
but the conclusion drawn is that 'chi was unblocked' or 'energy was
transferred.'

18. THE PRAGMATIC FALLACY
The pragmatic fallacy is common in "alternative" health claims and is often
based on post hoc reasoning. For example, one has a sore back, wears the
new magnetic or takionic belt, finds relief soon afterwards, and declares that
the magic belt caused the pain to go away. How does one know this?
Because it works! There is also some equivocation going on in the alternative
health claims that fall under the heading of "energy medicine," such as
acupuncture and therapeutic touch. The evidence pointed to often uses
'works' in the sense of 'the customer is satisfied' or 'the patient improves,'
but the conclusion drawn is that 'chi was unblocked' or 'energy was
transferred.'

19. THE PRAGMATIC FALLACY
The pragmatic fallacy is common in "alternative" health claims and is often
based on post hoc reasoning. For example, one has a sore back, wears the
new magnetic or takionic belt, finds relief soon afterwards, and declares that
the magic belt caused the pain to go away. How does one know this?
Because it works! There is also some equivocation going on in the alternative
health claims that fall under the heading of "energy medicine," such as
acupuncture and therapeutic touch. The evidence pointed to often uses
'works' in the sense of 'the customer is satisfied' or 'the patient improves,'
but the conclusion drawn is that 'chi was unblocked' or 'energy was
transferred.'

20. What about in Turkey?

23. Evidence and experiments

27. Randomisation
• Used to minimise bias in allocating participants to the arms of an
experiment
• Can be done in a variety of ways normally using random numbers
• Where randomisation is impossible then other designs can be used:
• Essentially quasi-experiments
• Or cluster designs

28. Control
• Used to minimise the effects of:
• Placebo effect
• Maturation/history
Essentially a group that is treated the same as the experimental group
But without the treatment
NB: very hard in social interventions

29. Blinding
• Used to minimise biased responses:
• by participants
• by data collectors
• Single-blind
• Double-blind

30. Sample size
• Power analysis
• Sample size is related to
• The statistical test to be used
• The effect size
• ie – the likely difference between the groups in the study
Cohen J (1992) A power primer Psychological Bulletin 112 155-159

32. ‘Recent’ designs
• Complex interventions
• Acknowledge the complexity of interventions
• Pragmatic trials
• Test under ‘real life’ conditions
• Non-inferiority trials
• Test to see if something is no worse

33. Principles of publishing CAM related articles

34. Enhancing the QUAlity and Transparency
Of health Research

35. Enhancing the QUAlity and Transparency
Of health Research
CONSORThttp://www.consort-statement.org/

37. Flowchart

38. Checklist

39. Trial registration

48. Follow the journal guidelines

51. Conclusion
• Research into CAM/CAT is not an excuse for poor designs or poor reporting
• Follow good experimental methods
• Register studies
• Report using CONSORT principles
• Follow specific journal guidelines

52. r.watson@hull.ac.uk
0000-0001-8040-7625
@rwatson1955