Talk:Complementary Medicine Evaluation Programme

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POV[edit]

This article needs serious cleanup - it is bristling with POV. --David.Mestel 17:11, 4 July 2006 (UTC)[reply]

I agree. I had a go at it in June 2007, but as I said then, it still needs work. Unfortunately for me, I don't read German; the only English Language information on the PEK that I have found is the 2006 Peter Fisher article. (However, I find his 1994 article "Complementary medicine in Europe" interesting reading.) Pdfpdf 07:42, 10 August 2007 (UTC)[reply]
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=8038643&dopt=Citation
I would say that recent efforts by a number of people have achieved the needed "serious cleanup", and the various POV are now attributed to their sources. Pdfpdf 15:41, 10 August 2007 (UTC)[reply]

September edits by anonymous users[edit]

We have the makings of an Edit War here, so let's stop it before it becomes one.

There's quite a string of edits - 4 anonymous editors, a Bot, Jmcw37 and Pdfpdf:

  • 71.193.193.109 - 1 edit - leaves explanation: correct spelling error
  • 85.3.158.94 - 3 edits - no explanation
Adds unreferenced/unsupported statement:
The actual collection of field data was, however, not started before Sept 2002 and data collection and scientific evaluation required only a fraction of the originally available financial resources. Most of available resources were spent on finding consensus and on how to organize the project prior to the actually performed field studies and literature reviews.
Deletes the referenced/supported statement:
With complementary medicine, the total annual costs are markedly lower than the average for conventional care. Overall, however, complementary practitioners treat fewer patients, and more frequently younger and female patients. Adjusted for these factors, the
  • Pdfpdf - 1 compound edit - leaves explanation: (a) Asks for evidence (b) Resurects deleted text as a hidden comment.
  • Bot
  • 85.3.37.158 - 1 edit - no explanation - puts in vague reference: "(see final PEK Report)"
(I examined the PEK Report (yet again). I couldn't find this statement.)
  • Jmcw37 - reverted the vague reference. (Presumably couldn't find the statement either.)
  • Jmcw37 - decided POV creeping in - reverted back to version after the 27 Aug spelling correction.
  • 85.1.238.203 - 1 compound edit - no explanation
    • Deleted a valid reference
    • Added a new statement very similar to previous statement.
    • Says "According to PEK Report", but as was previously the case, the statement still isn't in the report.
    • Added reference to the "Evaluation" report; the statement most certainly is not in that report either.
    • Took a statement that is a direct quote from the PEK Report and changed it into a statement with the opposite meaning.
  • Jmcw37 tried to improve the situation thus created.
  • Pdfpdf says: "No, it's too far gone. Let's go back to 27 August, and discuss it here on this talk page.

Pdfpdf 11:55, 12 September 2007 (UTC)[reply]

85.3.158.94, 85.3.37.158 and 85.1.238.203 are all from the same dial-in internet provider. It could be one user. jmcw 14:29, 12 September 2007 (UTC)[reply]

more edits are required ...[edit]

The current introduction is misleading and implies that 7 million CHF were spent on a few literature reviews and on a field study that lasted only two years. Pages 19-21 of the PEK final report provide a description of the project organization, including a notion of fundamental conflicts among experts and a list of organizational difficulties. In addition, a time table from 1998 to 2005 shows how resources were distributed across time. Given these information the first paragraph of the page should be complemented as follows:

“According to the final PEK Report, four years of project time (1998-2002) were needed to find consensus among experts on how to organize the project and for the same reasons the concept of the economic evaluation was not finalized before Oct. 2003. Literature reviews and field studies could therefore not be initiated before Sept 2002 and required consequently only a fraction of the originally available resources (pages 19-21 of the final PEK report)."

The text describing the results of the economic evaluations is suggestive and implies that complementary medicine is cheaper then conventional procedures. However, overall treatment costs of complementary physicians were simply lower because they were treating fewer and younger, cost favorable patients. A paper listed on the website of the Swiss Federal Office of Health provides a more in depth analysis of this issue and based on these findings the text needs to be changed:

“The results of economic evaluations indicated no significant differences between complementary and conventional primary care for the overall treatment cost per patient. However, complementary practitioners treated lower numbers of patients and had a more cost-favorable patient population than conventional physicians. Additional analyses aimed at differences in cost structure reflected more patient-centred and individualized treatment modalities in complementary medicine.”

Additional text changes, also based on scientific data listed on the website of the Swiss Federal Office of Health are required the section describing part 1 of the project:

“…. These patients tend to have a favorable attitude towards complementary medicine and to exhibit chronic and rated the severity of their diseases as more severe. However, generic general health assessments were not different between patient groups. Technical diagnostic …”

… and

"…. On the basis of the statistics produced by the PEK, the question of whether complementary medicine should be regarded as being utilized in addition to or, rather, instead of conventional care cannot be definitively answered.
However, additional research in this context provided empirical evidence that patients of complementary physicians were requiring more physician-based medical services than users of conventional medicine although indicators of general health were comparable between patient groups. Inappropriate utilization of health related resources of patients consulting complementary practices could not be excluded and it remained therefore debatable whether an inclusion of complementary in basic Swiss health insurance would be cost neutral”

Comment added by 85.3.136.46 (talk) 20:05, 12 September 2007 (UTC) ---[reply]

Thank you for your detailed reply. I will respond when I have had time to absorb what you have written. In the meantime, you have referred to a number of documents; do you think you could provide citations for those documents? If so, that would be really good; currently, other readers are unable to read what you have read and agree with you. Pdfpdf 23:00, 12 September 2007 (UTC)[reply]

P.S. Have you you considered creating a user name? Un-cited/un-referenced comments from anonymous users do not have the credibility that comments with supporting evidence have. Pdfpdf 23:00, 12 September 2007 (UTC)[reply]

References[edit]

(All listed at the website of the Swiss Federal Office of Health):

PEK project organization:

  • English summary of PEK report, second paragraph
  • Chapter 3 of the final PEK report
  • Summary Consensus Statement of the PEK Review Board regarding the PEK process and the PEK products, Chapter 1

Economic analyses / utilization of health related resources

  • Chapters 6.3 and 6.4 of the final PEK report
  • Crivelli L. Il consumo di 5 terapie di medicina complementare in Svizzera. Scuola Uinversitare Profesionale della Svizzera Italiana, 2004
  • Busato A. Health status and health care utilisation of patients in complementary and conventional primary care in Switzerland--an observational study. Fam Pract 2006;23(1):116-24.
  • Busato A. Extent and structure of health insurance expenditures for complementary and alternative medicine in Swiss primary care. BMC Health Serv Res 2006;6:132.

Comment added by 85.3.140.230 (talk) 15:46, 13 September 2007 (UTC)[reply]

Please excuse my rudeness in reformatting your contribution, but I was having trouble reading it.
Wow! Very thorough. Thankyou. Pdfpdf 16:03, 13 September 2007 (UTC)[reply]

Discussion[edit]

The current introduction is misleading and implies that 7 million CHF were spent on a few literature reviews and on a field study that lasted only two years.

I'm puzzled by this statement. The current introduction doesn't make any mention of a few literature reviews and a field study that lasted only two years.. I don't see the introduction implying this. I'm afraid I'm confused. Can you explain further please?

Pages 19-21 of the PEK final report provide a description of the project organization, including a notion of fundamental conflicts among experts and a list of organizational difficulties. In addition, a time table from 1998 to 2005 shows how resources were distributed across time.

Agreed.

Given these information the first paragraph of the page should be complemented as follows:

“According to the final PEK Report, four years of project time (1998-2002) were needed to find consensus among experts on how to organize the project and for the same reasons the concept of the economic evaluation was not finalized before Oct. 2003. Literature reviews and field studies could therefore not be initiated before Sept 2002 and required consequently only a fraction of the originally available resources (pages 19-21 of the final PEK report)."
Something similar should appear in the body, but this is far too much detail for the first paragraph and the introductory section. I don't agree that this should appear in the first paragraph. Yes, it should appear in the body, but not in the introduction.

The text describing the results of the economic evaluations is suggestive and implies ...

Perhaps it does, but it's a direct copy from the PEK Report English summary. Thats what the article says: The section header is "Summary of the PEK Report", and immediately before the sub-header "Background" is the sentence: The following sections are extracts from the English summary of the PEK report:. Whether you (or I) agree with it or not is not the point; it is an attributed quote.
If you disagree with it, and you want to say something different, by all means do so, but not in this section. It's not appropriate in this section, because this section is a Summary of the PEK Report. It's not a summary of the study, it's a summary of the PEK Report.
Your intent is not clear to me - I can't work out if you agree or disagree with the PEK Report, and/or you agree or disagree with the English Summary (pp19-21), or what it is that you are trying to achieve. In any and all cases, any such comment/statement needs to appear in a separate section - perhaps a new section titled something like "Detail and basis of findings"? An alternative would be to put such statements in as Footnotes (example[1])
Example of a footnote:
  1. ^ This is an example of a footnote. This text is entered next to what it is referring to, but on the finished page (usually) appears near the bottom of the article in a "References" or "Footnotes" or "Notes" section.

... the text needs to be changed ...

No, I disagree. As descibed above, a new section with a relevant title needs to be created, and this additional information placed in that section. (In my opinion, this would add depth to the article, and hence would be an improvement.)

Additional text changes, also based on scientific data listed on the website of the Swiss Federal Office of Health are required the section describing part 1 of the project ...

Are these direct quotes from that section of the PEK Report? If so, yes, I agree. If not, no, they should either appear in a different section, or perhaps as a footnote.[1]
I hope this helps. Don't hesitate to ask for clarification if it's not clear. Pdfpdf 00:21, 14 September 2007 (UTC)[reply]


Ok, lets do an additional section dedicated to results that were apparently published outside the final PEK report.

However, the notion of 7 Mio CHF project cost mentioned in the first paragraph needs to be removed. The source of this information is not properly referenced in the ECH report and there is conflicting data about this. See http://www.dzvhae.com/portal/pics/abschnitte/100507031733_pekmemora05.12.11.pdf / page 19) Respectively there is currently no solid information at all available on this issue. 85.3.6.123 (talk) 05:56, 15 September 2007 (UTC)[reply]


Ok, lets do an additional section dedicated to results that were apparently published outside the final PEK report.
OK.
However, the notion of 7 Mio CHF project cost mentioned in the first paragraph needs to be removed. The source of this information is not properly referenced
I agree that any statement in the first paragraph should have much better supporting evidence than that statement has.
Rather than remove it, I considered moving it down into the summary of the ECH report. However, it doesn't fit there, either; it's unrelated to the thrust of the ECH report - it's just a "random", unrelated, unsubstantiated, "statement", and doesn't seem to add anything useful to the topic. Hence, I've removed it. (This section revised Pdfpdf 16:08, 15 September 2007 (UTC))[reply]
The source of this information is not properly referenced
I think you are being generous and/or polite! As far as I can tell, it's a statement with no supporting reference(s).
See http: ... page 19
I can still read Dutch (sort of), and hence can still get some sense out of a paragraph of German, but I'm afraid my German is not good enough to identify the section you're referring to. If it's not too much trouble, would you mind paraphrasing the relevant section for me please?
Respectively there is currently no solid information at all available on this issue.
I'm sorry, but I don't quite understand what you mean when using the word "Respectively" in this sentence.
Do you mean the same as "Hence" or "Thus"? Or do you mean something else?
there is currently no solid information at all available on this issue.
Well, there must be some solid information somewhere ...
Shall we just agree that: "Currently, we have not been able to find any solid information on this issue"?
Cheers, Pdfpdf 15:48, 15 September 2007 (UTC)[reply]

There is currently an administrative investigation ongoing aimed at potential financial irregularities within the PEK Project. A report is due this fall and will include solid data on the overall cost of the project … 85.3.45.57 (talk) 04:46, 16 September 2007 (UTC)[reply]

Interesting! Pdfpdf 05:04, 16 September 2007 (UTC)[reply]

Addition of new section to article[edit]

Ok, lets do an additional section dedicated to results that were apparently published outside the final PEK report.

OK. Where do you want to start? Pdfpdf 05:04, 16 September 2007 (UTC)[reply]


V. Bad article indeed[edit]

Controversy section should need to go. There is no controversy mentioned! Merely angry reaction from people who were pissed off ny the report. It needs to be pared down into a proper wikipedia style, no bullet points. It needs to be renamed "responses". And BLP info on the doctors involved needs to go too. Lobojo (talk) 18:29, 20 December 2007 (UTC)[reply]


There is disagreement between "school" medicine and complementary medicine over reality. School medicine demands very strict rational proof of effectiveness. People do not demand strict ration proof: they are satisfied when a procedure is perceived as helpful. Between these two groups, there is a gap of beliefs and therefore constant controversy. To make this wiki article balanced, both views are presented. I think it was a goal of PEK to narrow this gap: I do not think it was successful. jmcw (talk) 07:51, 21 December 2007 (UTC)[reply]

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  1. ^ Another example of a Footnote.
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