The Clinician's Alternative

iCaduceus: Modern Tools for the Eclectic Clinician

We have been asked why we include what we include, are treatments ranked and are they referenced. In essence, people what to know if iCaduceus is evidence-based? The short answer is yes, but we wish to appropriately define evidence-based medicine. Both the US and UK have a four stage classification of scientific exploration. From the Oxford Center for Evidence Based Medicine the categories are defined as follows1:

• Level A: Consistent Randomised Controlled Clinical Trial, cohort study, all or none (see note below), clinical decision rule validated in different populations.
• Level B: Consistent Retrospective Cohort, Exploratory Cohort, Ecological Study, Outcomes Research, case-control study; or extrapolations from level A studies.
• Level C: Case-series study or extrapolations from level B studies.
• Level D: Expert opinion without explicit critical appraisal, or based on physiology, bench research or first principles.2

This definition includes a very important level in the last category which is "based on physiology". Much of Naturopathic medicine has the goal of restoring physiology and an understanding of it is required to properly treat the patient. Our goal at iCaduceus: The Clinician's Alternative is to provide as much information about what is used in various alternative medical circles without ratings. Each treatment has been through some level of the above rating and where applicable references cited.

We have also been asked as to why we don't provide a grading system to the research such as "The Natural Standard".  First, "The Natural Standard" is an excellent compendium of the evaluation of peer-reviewed Evidence Based Medicine. We did not want to replicate their body of work. Their work only includes items (by definition) that have been researched in published in many journals. But the research of alternative medical treatments only includes a small fraction of the total treatments available. Many treatments such as Ginkgo Biloba have been extensively researched (over researched?) due to the way that funding has worked in this and other countries. We decided that we wanted to include treatments that have not been researched but have been clinical verified by practitioners over time.  For that reason, many of the items in our database have almost no studies to associate with them.

Most importantly, is that our goal is to create an understanding as to why treatments may or may not work. There have been many treatments where sound scientific studies both refuted and supported the usage of the treatments. Our goal at iCaduceus is less about the evaluation of these treatments but rather an exploration of understanding the physiology around what sorts of patients will benefit from the treatment and w 

We would like to invite you to share your stories of treatments that did and did not work. For now, please feel free to leave comments with each treatment or condition as feedback. We will be providing a form in early 2009 to allow for more streamlined information that will allow us to rank treatments. In the meantime, please feel free to send feedback, comments or any other suggestions. 

1. 1. Oxford Centre for Evidence-based Medicine Levels of Evidence and Grades of Recommendation
2. 2.  http://en.wikipedia.org/wiki/Evidence-based_medicine