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Invited Commentary |

Moving Toward Evidence-Based Complementary Care

Allan H. Goroll, MD1,2
[+] Author Affiliations
1Harvard Medical School
2Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts
JAMA Intern Med. 2014;174(3):368-369. doi:10.1001/jamainternmed.2013.12995.
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Therapies that lie outside the spectrum of traditional, science-based clinical medicine and surgery are often labeled as complementary or alternative. These therapies range from herbal remedies and dietary supplements to meditation and acupuncture, and they derive from Eastern and Western traditions. Use is widespread and often promoted by commercial interests and practitioners, with prevalence estimates exceeding 50%.1 Their popularity derives in part from being available without prescription and the supposition that the label of natural makes them safe and preferable to pharmacologic and surgical treatments.2 Despite widespread use, many complementary therapies still lack a rigorous evidence base.3

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An ax to grind on meditation?
Posted on January 8, 2014
Charles Pierson, Ph.D.
Western New York Children's Psychiatric Disorder
Conflict of Interest: Dr. Pierson teaches classes in Mindfulness Based Stress Reduction
Dr. Goroll mistakenly includes meditation in the category of \"Therapies that lie outside the spectrum of traditional, science-based clinical medicine and surgery....\" There are hundreds of studies published each year on Mindfulness Based Stress Reduction or similar mindfulness meditation interventions. Many of these studies are in the area of the neuroscience of meditation, conducted with our most advanced brain imaging technology. The latest study from Richard Davidson and colleagues at the Center for Investigating Healthy Minds at the University of Wisconsin shows that meditation can affect gene expression in expert meditators. While it is highly desirable to have better designed and longer-term studies on meditation, as it is for any intervention, it strikes me as an error in judgment to put meditation in the same category as herbal remedies or other alternative approaches that have considerably less research published on their effects. His own commentary acknowledges that meditation is as effective as some other interventions, and without the side effects of pharmacologic treatment. It makes one wonder if Dr. Goroll has an ax to grind.
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