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Abstract

Evidence-based medicine (EBM) has as its aim and concern the identification and evaluation of the entire body of published evidence concerning a medical problem with a view to making the results available, assessable and easily usable in medical practice. It therefore sees itself first and foremost as an instrument of medical decision-making with the task of supporting physicians in their day-to-day work with patients. EBM’s central stipulation is the provision of external evidence in the form of scientifically verified knowledge.

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References

  • Agency for Health Care Policy and Research (AHCPR). Acute pain management: operative and medical procedures and trauma. Clinical practice guideline No.1. AHCPR Publication 1992 No. 92–0023, Appendix B. available at: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat6.table.9286

  • Alderson P, Green S, Higgins J (2004) Cochrane Reviewers’ Handbook. Handbook 4.2.1. [updated December 2003]. John Wiley & Sons Ltd, Chichester

    Google Scholar 

  • Altman DG, Bland JM (1995) Absence of evidence is not evidence of absence. BMJ 311 :485

    PubMed  CAS  Google Scholar 

  • Bornhöft G, Maxion-Bergemann S, Wolf U, Kienle G, Michalsen A, Vollmar H, Gilbertson S, Matthiessen P (2006) Checklist for the qualitative evaluation of clinical studies with particular focus on external validity and model validity. BMC Med Res Methodol 6:56

    Article  PubMed  Google Scholar 

  • Bundesamt für Sozialversicherung der Schweiz (ed) (1996)Handbuch zur Standardisierung der medizinischen und wirtschaftlichen Bewertung medizinischer Leistungen, 3rd edn. Bern

    Google Scholar 

  • Cochrane Collaboration (2002) The Cochrane Collaboration open learning material. 13: Diversity and heterogeneity. Available at: http://www.cochrane-net.org/openlearning/HTML/mod13-4.htm

  • Crowley T, Low N, Turner A, Harvey I, Bidgood K, Horner P (2001) Antibiotic prophylaxis to prevent post-abortal upper genital tract infection in women with bacterial vaginosis: randomized controlled trial. BJOG Int J Obstet Gynaecol 108:396–402

    Article  CAS  Google Scholar 

  • De Flora S, Grassi C, Carati L (1997) Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment. Eur Respir J 10:1535–1541

    Article  PubMed  Google Scholar 

  • Dickersin K (2003) The mammography debate: a crisis for evidence-based medicine? In: 4. Symposion Evidenzbasierte Medizin. 14–15 March, 2003,Freiburg i.Br.

    Google Scholar 

  • Editorial (2005) The end of homeopathy. Lancet 366:690; DOI:10.1016/S0140-6736(05)67149-8

    Google Scholar 

  • Ernst E (2004) Author’s reply. Wien Klin Wochenschr 11 6:408

    Article  Google Scholar 

  • Fisher P, Berman B, Davidson J, Reilly D, Thompson T (2005) Are the clinical effects of homeopathy placebo effects? Lancet 366:2082–2083; DOI:10.1016/S0140-6736(05)67879-8

    Article  PubMed  Google Scholar 

  • Gill P, Dowell AC, Neal RD, Smith N, Heywood P, Wilson AE (1996) Evidence-based general practice: a retrospective study of interventions in one training practice. BMJ 312:819–821

    PubMed  CAS  Google Scholar 

  • Godwin M, Ruhland L, Casson I, MacDonald S, Delva D, Birtwhistle R, Lam M, Seguin R (2003) Pragmatic controlled clinical trials in primary care: the struggle between external and internal validity. BMC Med Res Methodol 3:28. DOI:10.11 86/1471-2288-3-28

    Article  PubMed  Google Scholar 

  • Greenhalgh T (1997) Assessing the methodological quality of published papers. BMJ 315:305–308

    PubMed  CAS  Google Scholar 

  • Habour R, Miller J (2001) A new system for grading recommendations in evidence based guidelines. BMJ 323:334–336

    Article  Google Scholar 

  • Heusser P (2001) Kriterien zur Beurteilung des Nutzens von komplementärmedizinischen Methoden. Forschende Komplementärmedizin und Klassische Naturheilkunde 8:14–23

    Article  PubMed  CAS  Google Scholar 

  • Higgins JPT, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558

    Article  PubMed  Google Scholar 

  • Hogel J, Walach H, Gaus W (1994) Change-to-Open-Label Design. Proposal and discussion of a new design for clinical parallel-group double-masked trials. Arzneimittelforschung 44:97–99

    PubMed  CAS  Google Scholar 

  • Horn J, de Haan RJ, Vermeulen M, Limburg M (2001) Very early nimodipine use in stroke (VENUS): a randomized, double-blind, placebo-controlled trial. Stroke 32:461–465

    Article  PubMed  CAS  Google Scholar 

  • Jacobs J, Jimenez LM, Malthouse S, Chapman E, Crothers D, Masuk M, Jonas WB (2000) Homeopathic treatment of acute childhood diarrhea: results from a clinical trial in Nepal. J Altern Complement Med 6:131–139

    Article  PubMed  CAS  Google Scholar 

  • Jonas WB, Kaptchuk TJ, Linde K (2003) A critical overview of homeopathy. Ann Intern Med 138:393–399

    PubMed  Google Scholar 

  • Kaplan MA, Prior MJ, McKonly KI, DuPont HL, Temple AR, Nelson EB (1999) A multicenter randomized controlled trial of a liquid loperamide product versus placebo in the treatment of acute diarrhea in children. Clin Pediatr 38:579–591

    Article  CAS  Google Scholar 

  • Khan KS, ter Riet G, Popay J, Nixon J, Kleijnen J (2001) STAGE II – Conducting the review. PHASE 5 – Study quality assessment. In: Khan KS, ter Riet G, Glanville J, Sowden AJ, Kleijnen J (eds) Undertaking systematic reviews of research on effectiveness. CRD Report Number 4 (2nd edn), York

    Google Scholar 

  • Kiene H (2001) Komplementäre Methodenlehre der klinischen Forschung. Cognition-based Medicine. Springer, Berlin Heidelberg New York

    Google Scholar 

  • Kienle G (1974) Arzneimittelsicherheit und Gesellschaft. Eine kritische Untersuchung. Schattauer, Stuttgart New York

    Google Scholar 

  • Kienle GS (2005) Gibt es Gründe für Pluralistische Evaluationsmodelle? Limitationen der Randomisierten Klinischen Studie. Z Arztl Fortbild Qualität Gesundheitswesen 99:289–294

    Google Scholar 

  • Kienle GS, Hamre HJ, Portalupi E, Kiene H (2004) Improving the quality of therapeutic reports of single cases and case series in oncology – criteria and checklist. Altern Therapies Health Med 10:68–72

    Google Scholar 

  • Kienle GS, Kiene H, Albonico HU (2006a) Anthroposophische Medizin in der klinischen Forschung. Schattauer, Stuttgart New York

    Google Scholar 

  • Kienle GS, Kiene H, Albonico HU (2006b) Anthroposophic medicine. Effectiveness, utility, costs, safety. Schattauer, Stuttgart New York

    Google Scholar 

  • Labrecque M, Audet D, Latulippe LG, Drouin J (1992) Homeopathic treatment of plantar warts. Can Med Assoc J 146:1749–1753

    CAS  Google Scholar 

  • Linde K, Clausius N, Ramirez G, Melchart D, Eitel F, Hedges LV, Jonas WB (1997) Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet 350:834–843

    Article  PubMed  CAS  Google Scholar 

  • Linde K, Jonas W (2005) Are the clinical effects of homeopathy placebo effects? Lancet 366:2081–2082; DOI:10.1016/S0140-6736(05)67878-6

    Article  PubMed  Google Scholar 

  • Lüdtke R (ed) (2006) Homöopathie – Zum Stand der klinischen Forschung. Eine Stellungnahme der Karl und Veronica Carstens-Stiftung. KVC, Essen. available at: www.carstens-stiftung.de/wissen/hom/pdf/Stand_der_Forschung_Homeopathie_07MAR06.pdf

  • Matthiessen PF (2003) Der diagnostisch-therapeutische Prozess als Problem der Einzelfallforschung. In: Ostermann T, Matthiessen PF (eds) Einzelfallforschung in der Medizin. Bedeutung, Möglichkeiten, Grenzen. VAS, Frankfurt

    Google Scholar 

  • Matthiessen PF (2005) Die Therapieentscheidung des Arztes. Z Arztl Fortbild Qualität Gesundheitswesen 99:269–273

    Google Scholar 

  • Moher D, Cook DJ, Jadad AR, Tugwell P, Moher M, Jonas A, Pham B, Klassen TP (1999) Assessing the quality of reports of randomized trials: implications for the conduct of meta-analyses. Health Technol Assess 3:i–iv, 1–98

    Google Scholar 

  • Moller C, Berg IM, Berg T, Kjellman M, Stromberg L (1994) Nedocromil sodium 2% eye drops for twice-daily treatment of seasonal allergic conjunctivitis: a Swedish multicentre placebo-controlled study in children allergic to birch pollen. Clin Exp Allergy 24:884–887

    Article  PubMed  CAS  Google Scholar 

  • Nicholson KG, Aoki FY, Osterhaus AD, Trottier S, Carewicz O, Mercier CH, Rode A, Kinnersley N, Ward P (2000) Efficacy and safety of oseltamivir in treatment of acute influenza: a randomized controlled trial. Neuraminidase Inhibitor Flu Treatment Investigator Group. Lancet 355:1845–1850

    Article  PubMed  CAS  Google Scholar 

  • Niroomand F (2004) Evidenzbasierte Medizin: das Individuum bleibt auf der Strecke. Dtsch Ärztebl 101:1870–1874

    Google Scholar 

  • Ollenschläger G, Helou A, Lorenz W (2000) Kritische Bewertung von Leitlinien. In: Kunz R, Ollenschläger G, Raspe HH (eds). Lehrbuch evidenzbasierte Medizin in Klinik und Praxis. Schriftenreihe Hans Neuffer Stiftung. Deutscher ÄrzteVerlag, Köln, pp 156–176

    Google Scholar 

  • Papp R, Schuback G, Beck E, Burkard G, Bengel J, Lehrl S, Belon P (1998) Oscillococcinum® in patients with influenza- like syndromes: a placebo-controlled double-blind evaluation. Br Homeopathic J 87:69–76

    Article  Google Scholar 

  • Penston J (2005) Large-scale randomized trials – a misguided approach to clinical research. Med Hypotheses 64:651–657

    Article  PubMed  Google Scholar 

  • Raoult D (2005) Are the clinical effects of homeopathy placebo effects? Authors‘ reply. Lancet 366:2085–2086; DOI:10.1016/S0140-6736(05)67883-X

    Article  Google Scholar 

  • Resch K (1998) Pragmatic randomized controlled trials for complex therapies. Forschende Komplementärmedizin. 5 [Suppl S1]:S 136–139

    Article  PubMed  Google Scholar 

  • Roland M, Torgerson DJ (1998) Understanding controlled trials: What are pragmatic trials? BMJ 316:285

    PubMed  CAS  Google Scholar 

  • Rottey E, Verleye G, Liagre R (1995) Het effect van een homeopathische bereiding van micro-organismen bij de preventie van griepsymptomen: een gerandomiseered dubbel-blind onderzoek in de huisartspraktijk. Tijdschr Integrale Geneeskunde 11 :54–58

    Google Scholar 

  • Sackett D, Richardson W, Haynes R (1997) Evidence-based medicine. How to practice and teach EBM. Churchill Livingstone, New York Edinburgh London

    Google Scholar 

  • Sackett DL (1979) Bias in analytic research. J Chronic Dis 32:51–63

    Article  PubMed  CAS  Google Scholar 

  • Schmidt JM, Ostermayr B (2002) Does a homeopathic ultramolecular dilution of Thyroidinum 30cH affect the rate of body weight reduction in fasting patients? A randomized placebo-controlled double-blind clinical trial. Homeopathy 91:197–206

    Article  PubMed  CAS  Google Scholar 

  • Shang A, Huwiler-Muntener K, Nartey L, Jüni P, Dörig S, Sterne JAC, Pewsner D, Egger M (2005a) Are the clinical effects of homeopathy placebo effects? Comparative study of placebo-controlled trials of homeopathy and allopathy. Lancet 366:726–732; DOI:10.1016/S0140-6736(05)67177-2

    Article  Google Scholar 

  • Shang a, Jüni P, Sterne JAC, Huwiler-Müntener K, Egger M (2005b) Are the clinical effects of homeopathy placebo effects? Authors‘ reply. Lancet 366:2083–2085; DOI:10.1016/S0140-6736(05)67881-6

    Article  Google Scholar 

  • SIGN 50 (Scottish Intercollegiate Guidelines Network). A guideline developer‘s handbook. Notes on the use of Methodology Checklist 2: Randomized Controlled Trials. available at: http://www.sign.ac.uk/guidelines/fulltext/50/notes2.html

  • Skandhan KP, Smith A, Avni A (2005) Are the clinical effects of homeopathy placebo effects? Authors’ reply. Lancet 366:2085; DOI:10.1016/S0140-6736(05)67882-8

    Article  Google Scholar 

  • Vickers AJ, Fisher P, Smith C, Wyllie SE, Rees R (1998) Homeopathic Arnica 30x is ineffective for muscle soreness after long-distance running: a randomized, double-blind, placebo-controlled trial. Clin J Pain 14:227–231

    Article  PubMed  CAS  Google Scholar 

  • Walach H, Haeusler W, Lowes T, Mussbach D, Schamell U, Springer W, Stritzl G, Gaus W, Haag G (1997) Classical homeopathic treatment of chronic headaches. Cephalalgia 17:11 9–126; discussion: p 1 01

    Article  Google Scholar 

  • Walach H, Jonas W, Lewith G (2005a) Are the clinical effects of homeopathy placebo effects? Lancet 366:2081; DOI:10.1016/S0140-6736(05)67877-4)

    Article  Google Scholar 

  • Walach H, Sadaghiani C, Dehm C, Bierman DJ (2005b) The therapeutic effect of clinical trials: understanding placebo response rates in clinical trials – a secondary analysis. BMC Med Res Methodol 5:26

    Article  Google Scholar 

  • Walach H (2001) Das Wirksamkeitsparadox in der Komplementärmedizin. Forschende Komplementärmedizin und Klassische Naturheilkunde 8:193–195

    Article  PubMed  CAS  Google Scholar 

  • Wegscheider K (2005) Was sind faire Vergleiche zwischen Therapien? Zeitschrift für ärztliche Fortbildung und Qualität im Gesundheitswesen 99:275–278

    PubMed  Google Scholar 

  • Wein C (2002)Qualitätsaspekte klinischer Studien zur Homöopathie. KVC, Essen

    Google Scholar 

  • Weiser M, Clasen B (1994) Randomisierte plazebokontrollierte Doppelblindstudie zur Untersuchung der klinischen Wirksamkeit der homöopathischen Euphorbium compositum-Nasentropfen S bei chronischer Sinusitis. Forschende Komplementärmedizin 1:251–259

    Article  Google Scholar 

  • White A, Slade P, Hunt C, Hart A, Ernst E (2003) Individualized homeopathy as an adjunct in the treatment of childhood asthma: a randomized placebo controlled trial. Thorax 58:317–321

    Article  PubMed  CAS  Google Scholar 

  • World Medical Association (2001) Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bull World Health Organization, 79:373–374. available at: http://whqlibdoc.who.int/bulletin/2001/issue4/79(4)declaration.pdf

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Matthiessen, P.F., Bornhöft, G. (2011). General problems with clinical trials in research. In: Bornhöft, G., Matthiessen, P.F. (eds) Homeopathy in Healthcare – Effectiveness, Appropriateness, Safety, Costs. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-20638-2_5

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