Background
Methods
Statistical analysis
Coding variable: clinical trials | Herbal remedy clinical trial (N = 57) | Pharmaceutical clinical trial (N = 48) | Statistical significance |
---|---|---|---|
Mean number of benefits | 1.6 | 1.4 | NS |
Mean number of risks | 0.9 | 1.1 | NS |
Mean sample size | 144 | 12,124 |
P < 0.0001 |
Mean duration of trial (days) | 124 | 1435 |
P = 0.008 |
Mean Jadad score | 3.2 | 3.1 | NS |
Dose specified | 94.7% | 72.9% |
P = 0.002 |
Trial described as randomized | 78.9% | 72.9% |
P = 0.001 |
Trial described as double-blind | 71.9% | 68.8% |
P < 0.001 |
Withdrawals and dropouts described | 82.5% | 79.2% | NS |
Conflicts of interest NOT specified | 77.2% | 50.0% |
P = 0.003 |
Funding of trial NOT specified | 33.9% | 8.3% |
P = 0.004 |
Coding variable: newspaper articles
| (N = 352) | (N = 201) | |
Mean word count | 698 | 716 | NS |
Mean number of benefits | 1.3 | 1.2 | NS |
Mean number of risks | 0.53 | 1.3 |
P < 0.0001 |
Source of funding NOT specified | 83.5% | 81.6% | NS |
Conflicts of interest NOT specified | 96.6% | 96.0% | NS |
At least one scientific/technical error in reporting on the trial | 99% | 99% | NS |
Duration of the clinical trial NOT specified | 59.7% | 57.2% | NS |
Sample size NOT specified | 41.5% | 29.4% |
P < 0.0001 |
Dose NOT specified | 81.0% | 95.5% |
P < 0.0001 |
Location of trial NOT specified | 32.1% | 32.3% | NS |
Randomization NOT specified | 89.2% | 94.0% | NS |
Double-blinding NOT specified | 90.3% | 98.5% |
P < 0.0001 |
Use of placebo NOT specified | 45.7% | 72.6% |
P < 0.0001 |
Withdrawals/dropouts NOT specified | 98.0% | 97.5% | NS |
Methodological limitations
Results
Clinical trials: herbal versus pharmaceutical
Newspaper articles: herbal versus pharmaceutical
Discussion
Implications of results
Appendix
Appendix 1: Coding frame for clinical trials
-
Not specified 0
-
University/hospital 1
-
Not-for-profit organization 3
-
Mixed 4
-
Private 5
-
Government 6
-
Not specified 0
-
Type of medical condition
-
Not specified 0
-
US 1
-
Canada 7
-
UK 2
-
Europe 3
-
Australia 4
-
South America 5
-
Asia 6
-
International 8
-
Mid East/Africa 9
-
balanced 2
-
or imbalanced 3
-
Not specified 0
-
None (stated that there is no benefit) 1
-
Basic research 2
-
Improved health/treatment 3
-
Decreased side-effects 4
-
General safety 5
-
Increased autonomy/empowerment 6
-
Spiritual, moral, ethical 7
-
Environmental/ecological/nature 8
-
Economic 9
-
Improved quality of life 10
-
Other (specify) 11
-
Not specified 0
-
High 1
-
Moderate 2
-
Low 3
-
No benefit (stated) 4
-
Mentioned but not quantified 5
-
Not specified 0
-
None (stated that there is no risk) 1
-
Basic research 2
-
Health 3
-
Increased side-effects 4
-
General safety 5
-
Decreased autonomy/empowerment 6
-
Spiritual, moral, ethical 7
-
Environmental/ecological/nature 8
-
Economic 9
-
Decreased quality of life 10
-
Other (specify) 11
-
Not specified 0
-
High 1
-
Moderate 2
-
Low 3
-
No risk/cost (stated) 4
-
Mentioned but not quantified 5
-
Not specified 0
-
Mentioned but none 1
-
Declared or obvious 2
-
Not specified 0
-
Public 1
-
Private 2
-
Mixed 3
-
Negative valuation of results 1
-
Positive valuation of results 2
-
Neutral valuation of results 3
-
Negative valuation 1
-
Positive valuation 2
-
Neutral valuation 3
-
Australia/New Zealand 1
-
Canada 2
-
UK/Ireland 3
-
USA 4
-
With these variables we are measuring the editorial importance of an article; the means used to attract the reader's attention.a.Word countb.News format
-
(here we are attempting to distinguish between facts and opinion)
-
Not specified 0
-
Article with latest news 1
-
Investigation, reportage, background 2
-
Interview (mainly) 3
-
Column, commentary by regular columnist 4
-
Editorial (paper's editor) 5
-
Commentary from other people (e.g. politicians, religious leaders, special interest groups) 6
-
Letters to the editor 7
-
Review of books, films, etc. 8
-
Other 9
-
-
Science/medicine
-
Clinical trial 1
-
Meta-analysis of clinical trials 2
-
Medical condition 3
-
Review of treatments for a medical condition 4
-
Review of uses of a particular herb 5
-
-
Safety/risks
-
Health risks: CAM 6
-
Health risks: traditional medicine 7
-
Other risks: CAM 8
-
Other risks: traditional medicine 9
-
-
Other issues
-
Patenting, property rights 10
-
Economic prospects, opportunities 11
-
Biopharmaceutical industry 12
-
CAM industry 13
-
Biodiversity/conservation 14
-
Legal/regulatory 15
-
Science policy 16
-
Education 17
-
Public opinion (e.g. survey results) 18
-
Public protest/demonstration 19
-
Ethical issues 20
-
Religious issues 21
-
-
Not applicable, unknown 0
-
Public sector
-
Parliament/congress 1
-
Government
-
General 2
-
Health 3
-
Industry 4
-
Environment 5
-
Patent Offices 6
-
-
Government research institutions/scientists (e.g. National Institutes of Health) 7
-
Specialist CAM researcher/practitioner 8
-
Non-CAM university or hospital scientists/physicians 9
-
Ethics committees 10
-
Judicial, legal voice 11
-
The public, public opinion (e.g. surveys) 12
-
The media, published opinion 13
-
Celebrity (sports, film TV) 14
-
-
Private sector – business
-
Scientists in private laboratories 15
-
Pharmaceutical company/spokesperson 16
-
CAM company spokesperson 17
-
Venture capital 18
-
Private investors 19
-
Stock Exchange 20
-
-
Private sector – other
-
Political parties 21
-
Religious organizations 22
-
Consumer groups 23
-
Patient groups/lobbies 24
-
Environmental organizations 25
-
Professional organizations (medical, legal, etc.) 26
-
-
International institutions
-
Developing countries 27
-
European Union 28
-
European Parliament 29
-
United Nations organizations 30
-
Other international organizations 31
-
-
balanced 2
-
or imbalanced 3
-
Not specified 0
-
None (stated that there is no benefit) 1
-
Basic research 2
-
Improved health/symptoms/condition 3
-
Decreased side-effects 4
-
General safety 5
-
Increased autonomy/empowerment 6
-
Spiritual, moral, ethical 7
-
Environmental/ecological/nature 8
-
Economic 9
-
Improved quality of life 10
-
Other (specify) 11
-
Not specified 0
-
High 1
-
Moderate 2
-
Low 3
-
No benefit (stated) 4
-
Mentioned but not quantified 5
-
Not specified 0
-
None (stated that there is no risk) 1
-
Basic research 2
-
Health/symptoms/condition 3
-
Increased side-effects 4
-
General safety 5
-
Decreased autonomy/empowerment 6
-
Spiritual, moral, ethical 7
-
Environmental/ecological/nature 8
-
Economic 9
-
Decreased quality of life 10
-
Other 11
-
-
Not specified 0
-
High 1
-
Moderate 2
-
Low 3
-
No risk/cost (stated) 4
-
Mentioned but not quantified 5
-
Not specified 0
-
Mentioned but none 1
-
Declared or obvious 2
-
Not specified 0
-
Public 1
-
Private 2
-
Mixed 3
-
Not specified 0
-
Specified 1
-
Not mentioned 0
-
Negative 1
-
Positive 2
-
Neutral 3
-
Negative valuation of results 1
-
Positive valuation of results 2
-
Neutral valuation of results 3
-
The clinical trial journal article 1
-
The authors of the clinical trial 2
-
Other scientists/physicians/practitioners 3
-
A press release/conference 4
-
A company spokesperson 5
-
A secondary source (e.g. other newspaper/review article) 6
-
Celebrities 7
-
Other commentators (please specify) 8
-
Not specified 0
-
Not specified 0
-
Yes, accurately 1
-
Yes, inaccurately 2
-
Not specified 0
-
Yes, accurately 1
-
Yes, inaccurately 2
-
Not specified 0
-
Yes, accurately 1
-
Yes, inaccurately 2
-
Not specified 0
-
Yes, accurately 1
-
Yes, inaccurately 2
-
Not specified 0
-
Yes, accurately 1
-
Yes, inaccurately 2
-
Not specified 0
-
Yes, accurately 1
-
Yes, inaccurately 2
-
None 1
-
1–3 2
-
>3 3
-
Negative 1
-
Neutral 2
-
Positive 3