evidence in support of private health insurance rebates for naturopathyanpa.asn.au/files/anpa...

Department of Health and Ageing

EVIDENCE IN SUPPORT OFPRIVATE HEALTH INSURANCE REBATES

FOR NATUROPATHY

JANUARY 2013

Suite 36/123 Camberwell RdEast Hawthorn VIC 3121

[email protected]

1800 422 885

Excellence, Leadership and Integrity in Naturopathic Health Care

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Contents

Executive Summary ................................................................................................................................. 2

Introduction ............................................................................................................................................ 2

Naturopathy as a Profession ................................................................................................................... 4

Evidence for the profession of Naturopathy .......................................................................................... 6

Search strategy ................................................................................................................................... 6

Research findings ................................................................................................................................ 6

Limitations of Naturopathy evidence ................................................................................................. 6

Whole systems research ..................................................................................................................... 7

Traditional evidence ........................................................................................................................... 8

Risk and Safety .................................................................................................................................... 8

Cost effectiveness ............................................................................................................................. 10

Prevention as a cost effective model ................................................................................................ 10

The Foundations Project ................................................................................................................... 11

Sub-standard training of health professionals in CAM ..................................................................... 11

Negative consequences of removing the rebate .................................................................................. 11

Conclusion ............................................................................................................................................. 12

ANPA Recommendations ...................................................................................................................... 13

Reference list ........................................................................................................................................ 14

Appendices ............................................................................................................................................ 16

Appendix 1 - Naturopathy: current perspectives ............................................................................. 16

Appendix 2 - Evidence table for Naturopathy .................................................................................. 21

Appendix 3 - Evidence table for Herbal Medicine ............................................................................ 35

Appendix 4 - Evidence table for Nutrition ........................................................................................ 49

Appendix 5 - Evidence table for Tactile Therapies ............................................................................ 59

Appendix 6 - Evidence table for Homoeopathy ................................................................................ 64

Acknowledgements ............................................................................................................................... 70

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Executive Summary

Naturopathy is a recognised profession both nationally and internationally. Millions of

Australians consult naturopaths because they achieve good outcomes for varied health

conditions. The public is engaging in proactive decision making in usually paying for these

consultations as an out of pocket expense. The government endorses this profession by

approving training and education in naturopathy in both the VET as well as the higher

education sectors. Naturopaths make a valuable contribution to the health support of

millions of Australians. The profession of Naturopathy is a repository for significant levels of

knowledge in complementary and alternative medicine (CAM). The public is seeking and

finding answers using CAM approaches that offer minimal harm and good outcomes.

Providing research that satisfies clinical efficacy, cost-effectiveness, quality and safety

evidence to maintain the rebates for the profession of naturopathy and the public is the

clear objective of the submission. Australians who choose private health insurance deserve

continued support and choice in pro-actively engaging in self funding healthcare. The small

rebate paid for naturopathy is a further endorsement by the government who already

approves the education of naturopathy providers in Australia. Private health insurers make

decisions to rebate for services based on market forces, not NHMRC evidence guidelines.

The Australian Naturopathic Practitioner Association (ANPA) puts forward convincing

evidence for the continued support by the government of the private health insurance

rebate for naturopathy services.

Introduction The Australian Naturopathic Practitioners Association (ANPA) thanks Prof Baggoley for the

opportunity to lodge this submission of evidence supporting the health insurance rebates

for the profession of naturopathy. The ANPA was founded in 1975 and is a national

association representing naturopaths. All members must have a minimum of an Advanced

Diploma of Naturopathy, although many have much higher qualifications. Our members

abide by a code of ethics as well as other policies that guide clinical practice. The ANPA

represents naturopaths in the following ways:

- Advocacy to government at State and Federal levels. - Support statutory registration for naturopaths. - Advocacy to private health insurers. - Participation in the review of the Health Training Package (VET Sector). - Foundation member and continued support for the Australian Register of

Naturopaths and Herbalists (ARONAH). - Significant focus on support for students and new graduates as they enter the

profession. - Ongoing educational and professionalization support for naturopaths. - Collaboration with other health professionals creating bridges of understanding to

improve health outcomes for the public.

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- Communication with education providers across Australia and overseas offering naturopathy training.

- Regular contributions to the media raising the profile of naturopathy and awareness for the profession amongst other health professionals, the public and the media.

A comprehensive synopsis of the issues currently affecting the profession of naturopathy is included. (see Appendix 1: Naturopathy: current perspectives) Private Health Insurance rebates for naturopathy services have been available since 1999¹.

Presently 10.5 million Australians have private health insurance cover. The 30 per cent

rebate from the government applies to both hospital cover and extras. Naturopathy rebates

fall into the ‘extras’ rebate category. The Howard government introduced these insurance

incentives to offer the public ‘choice’ and relieve pressure on the public hospital system¹.

Australia, like other developed societies, is challenged with rising health costs. According to

Baer support for complementary medicine by both sides of government may be a strategy

for curtailing rising health costs and is rarely mentioned in the health economics literature².

The benefits that were paid in 2010-11 for natural therapies were approximately 0.8% of the

total benefits paid, and this equated to approximately $27 million in subsidy from the

rebate³.

Naturopaths are primary contact health practitioners and offer the Australian public

approximately 4.9 million consultations per year⁴. Naturopaths are the largest group of

complementary and alternative medicine practitioners in Australia⁵. Determining accurate

numbers of naturopaths continues to be a problem because there is no formal register.

There could be as many as 10, 000 naturopaths in Australia. This is substantially more than

4000 - the total number of Chinese medicine practitioners registered in 2012⁶. Nearly 10%

of Australian women consult naturopaths⁷ and this number rises to 16% in conditions such

as cancer⁸. Rebate decisions will impact many health consumers as well as the practitioner

naturopaths who offer these services. The public are turning to naturopaths for many

reasons: they prefer natural medicine approaches, they have experienced adverse side

effects from pharmaceuticals and conventional medical approaches, want to try other

options and want a more holistic approach⁹.

This submission covers the following: Executive summary, Introduction, Naturopathy as a

profession, Evidence for the profession of Naturopathy, Negative consequences of removing

the rebate, Conclusion and Recommendations.

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Naturopathy as a Profession The profession of Naturopathy was founded by Benedict Lust who defined the name in New

York in 1896¹⁰. Naturopathy is a distinct health profession: both an art and a science and

its model of care is underpinned by six foundational principles. These principles are kept in

mind when a naturopath takes the case, develops a treatment plan, and supports a client’s

ongoing wellness. These six principles are:

Utilising and harnessing the power of nature – that the body, mind and spirit has the

inherent ability and potential to self correct and achieve homeostasis.

first do no harm – that whatever we suggest or prescribe, whether it be ingestible

substances, or a lifestyle or dietary change, we are not causing harm.

find and treat the cause whenever possible – we do not ignore the symptoms, we

treat and alleviate them, but are always seeking to identify and treat the underlying

driver of the problem and find the underlying cause.

treat the whole patient – identifying early on what the clients’ beliefs are about

their health care, who their support systems are, what matters to them, what are

their priorities, and how we can align care with who this person is beyond only

referencing their labelled diagnosis.

education – naturopath as teacher and facilitator fully informs, empowers and

guides improved understanding so that the client is more likely to make improved

health choices.

prevention – naturopathy is a different paradigm from conventional medicine. This

difference is apparent in how we take a case, identify and understand and treat a

dis-ease or functional physiological imbalance long before it becomes a diagnosable

pathology. This ability is a true strength of what the paradigm of naturopathy has to

offer. We are preventative medicine specialists.

Naturopathy is also defined as:

Naturopathy applies traditional, empirical, biomedical and scientific knowledge to optimise health and to prevent and treat disease. The principles of naturopathy are: supporting the body's innate healing power; identifying and treating the causes of illness; treating the whole person; promoting optimum health and preventing disease; and educating and actively engaging patients in the management of their health. Naturopathy is underpinned by holistic considerations of human health - physical, mental, spiritual and environmental. The practice of naturopathy utilises a range of modalities that are congruent with these principles. These commonly include dietary and lifestyle advice, nutritional medicine, herbal medicine, tactile therapies and homeopathy (Southern Cross University, School of Human Health Science, 2009).

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Naturopathy is recognised as a traditional medicine by the World Health Organisation WHO member states cooperate to promote the use of traditional medicine for health care. The collaboration aims to:

- support and integrate traditional medicine into national health systems in combination with national policy and regulation for products, practices and providers to ensure safety and quality;

- ensure the use of safe, effective and quality products and practices, based on available evidence;

- acknowledge traditional medicine as part of primary health care, to increase access to care and preserve knowledge and resources; and

- ensure patient safety by upgrading the skills and knowledge of traditional medicine providers. Australia is a WHO member state.

http://www.who.int/mediacentre/factsheets/fs134/en/

Naturopathic treatments are diverse and may include different modalities.

Figure 1. Naturopathy and the diverse modalities used in practice.

Core modalities in naturopathy may include: herbal medicine, nutritional medicine,

homeopathy, dietary and life-style advice as well as tactile therapies. Naturopaths may also

incorporate additional skills in their treatment protocols. Some naturopaths specialise in

certain modalities, others are generalists. Naturopaths diagnose using physical examination

and assessment of pathology testing. Naturopaths have medication formulation and

prescribing rights under the Therapeutic Goods Act 1989.

Naturopathy

modalites

herbal medicine

homeopathy

nutritional medicine

dietary and lifestyle advice

http://www.who.int/mediacentre/factsheets/fs134/en/

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Evidence for the profession of Naturopathy

Search strategy

Electronic searches were conducted in the following databases: Pubmed, CINHAL, Medical

Complete, Scopus, Informit, Health Source, Web of Science, Cochrane Library, and Google

Scholar. Search terms were confined to the main keywords of ‘naturopathy’ and clinical

efficacy, cost effectiveness, safety and quality. Additional research citations are not included

(due to time constraints for this submission) from unpublished papers from conferences as

well as citations from CAM keyword searches that are broad ranging for the complex and

varied modalities used by naturopaths. A recent poster presentation by Calabrese et al. at

the International Research Congress on Integrative Medicine and Health (2012) ‘Systematic

review of clinical studies of whole practice naturopathic medicine’ identified 12 studies

that fitted the PRISMA guidelines for systematic reviews. The authors concluded that the

review showed evidence of efficacy and cost savings. Available at:

http://www.biomedcentral.com/1472-6882/12/S1/P332

Research findings

As an emerging profession, evidence according to NHMRC guidelines is presented in

Appendix 2. The evidence tables are set out under the following headings: Naturopathy, and

then modalities used in naturopathic practice: Herbal Medicine, Nutritional medicine,

Tactile therapies and Homeopathy. Each of these sections is then further divided into the

specified criteria of clinical efficacy, cost-effectiveness, quality and safety. In the day to day

naturopathy clinical practice, text books using evidence are commonly used to support

treatment decisions as well as other evidence platforms. Authors of some of these

significant texts used by naturopaths are Australian. These include: Associate Professor

Kerry Bone, Dr Lesley Braun, Leah Hechtman, Dr Jerome Sarris, Dr Jon Wardle to name a

few.

Limitations of Naturopathy evidence

Whilst there is limited evidence for the efficacy of CAM products and practices (including

naturopathy), there is an equal lack of proof of ineffectiveness¹¹. This lack of research may

be due to the limited numbers of practitioners with skills and intellectual capital to conduct

the research as well as philosophical differences to the hierarchy of evidence¹². Competition

for CAM funding against pharmaceutical companies is a significant limitation¹³. Projects for

CAM research are also not seen as a priority¹⁴. There is now recognition that the most

relevant research model design to answer the question for naturopaths is Whole Practice

Based Research. This particular model is not included in current NHMRC guidelines.

The absence of evidence does not imply evidence of absence. Dr Carl Sagan

http://www.biomedcentral.com/1472-6882/12/S1/P332

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Whole systems research

Naturopathic medicine incorporates a wide range of treatments or modalities to provide

individualised care. Naturopathy’s unique approach to patient care is ideally suited to a

whole systems research (WSR) model.

According to Verhoef et al:

This framework is non-hierarchical, cyclical, flexible and adaptive as knowledge

creation is continuous, evolutionary and necessitates a continuous interplay between

research methods and ‘phases’ of knowledge. It must hold qualitative and

quantitative research methods in equal esteem.¹⁵

The gulf between randomised controlled trials and complex individualised patient care has

been raised repeatedly; the exclusion of social and environmental evidence through a strict

hierarchy, and the de-emphasis of qualitative evidence that helps explain the needs and

values of patients is at the expense of holistic care¹². Whole systems research may provide a

better assessment of complementary and alternative therapies than classic Randomised

Controlled Trials¹⁶.

The conclusion of the current ‘NHMRC additional levels of evidence and grades for

recommendations for developers of guidelines’ the NHMRC clearly states that some types of

evidence have not been captured in the new grading approach ‘specifically the appraisal of

qualitative studies and cost-effective analyses’. The government further states ‘that the

basis for appraising and synthesizing this type of evidence is undergoing refinement.’

In 2010 the National Institutes of Health (NIH) in the USA commissioned the Office of

Behavioural and Social Sciences Research to develop rigorous resource to evaluate mixed

methods research applications. The NIH deemed a priority exists because of the surge of

methodological diversity that is facing public health: population disparities, age groups,

ethnicities, cultures, poor adherence to treatments thought to be effective, behavioural

factors, disability, translational needs, interdisciplinary research teams and multi-level

approaches to explore complex health problems¹⁷. The ANPA recognises that these moves

on the part of the NIH to develop these more comprehensive models for health science

research may more fully answer the research question for the profession of naturopathy.

The Patient-Reported Outcomes Measurement System (PROMIS™) is an efficient, precise

and flexible measurement of efficacy of treatment especially for chronic diseases¹⁸. This

measurement tool may offer naturopaths a valid instrument for gathering outcomes data

from their patients who often present with complex chronic diseases. Collaboration

between public health and naturopathy research models may provide opportunities to

improve health outcomes because underlying principles of naturopathy and public health

are analogous¹⁹.

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Traditional evidence

Traditional knowledge is not simply ‘anecdotal’ but a form of empirical knowledge –

the collective accumulation of individual observations by generations of practitioners,

in some cases over hundreds of years. These observations have been systematically

structured by practitioners based on cycles of empirical observation to understand

cause and effect. Anecdotes in contrast are fragmented and lack unification or the

value of repeated experience¹⁴. Bensoussan 2004

Naturopathy incorporates this traditional collective evidence as a fundamental basis of

every day practice. For example the traditional use of a herbal medicine from a materia

medica or a herbal monograph continues to be an important part of the knowledge basis

that informs the practice of a naturopath in the herbal medicine dispensary today.

Risk and Safety

Naturopathy uses complex approaches to treatment. The bubble graph developed by

Juderon and Associates (2011) shows clearly that the societal risk of death in Australia from

the use of CAM is a dot too small to print. Naturopaths are specialists in the use of many of

these complementary medicines. Tax payers are fully subsidising a Medicare system with

enormous risk of death from preventable iatrogenic injury in hospitals and pharmaceutical

adverse reactions in hospitals (see graph below). It is important to note that in spite of very

low risk compared to conventional medicine provided in hospitals and via complementary

medicines, research has identified that there is some risk to the public. For example herb

drug interactions are a consideration today as they may cause adverse reactions if not

administered and monitored correctly. Lack of regulation of naturopathic education has

resulted in risks to patients via reduced standards²⁰. Naturopaths and Western herbal

medicine practitioners will experience one adverse event every 11 months of full-time

practice, with 2.3 adverse events for every 1000 consultations (excluding mild

gastrointestinal effects) ²¹.

Statutory registration for naturopaths has been called for in order to protect the public.

This was the preferred model of regulation recommended as a result of the Lin Report

tabled in 2005²². Governments have been slow to act on this important recommendation

since then. The formation of the Australian Register of Naturopaths (ARONAH)

www.aronah.com.au is in the process of creating a register during 2013 for the profession

so that they are registration ready. Statutory registration under the Australian Health

Practitioners Regulatory Authority (AHPRA) will establish minimal standards for education,

offer an independent complaints mechanism for the public and health professionals as well

as legally protect the ‘title’ for the profession of naturopathy.

http://www.aronah.com.au/

Cost effec veness A study conducted by Access Economics for the Na onal Ins tute of Complementary Medicine (NICM) found that the na on could poten ally save millions in healthcare costs without compromising pa ent outcomes if complementary medicine is more widely used²³. Naturopaths are ideally placed to offer these complementary medicines for depression, heart disease and osteoarthri s as they are significantly trained in the use of these modali es; nutri onal medicine - fish oil, herbal medicines St John’s Wort and Phytodolor.

‘With the increasing rates of chronic disease, an aging popula on and ballooning health costs, now is the me to redouble our efforts in CM research, and to focus on implemen ng the evidence through integra ve clinical practice.’ NICM 2012

A pragma c RCT has demonstrated the cost effec veness of naturopathic care to society, employer and par cipants for chronic low back pain²⁴. The Na onal Advisory Council to the NIH Na onal Centre for Complementary and Alterna ve Medicine in the USA confirmed a concept paper ‘The effec veness and and cost-effec veness of CAM as prac ced in community se ngs.’ This will offer outcomes for pa ents that include: becoming more func onal, gaining higher quality of life, diminishing the use of pharmaceu cals, suffering fewer adverse effects of drugs, needing fewer tests and procedures, limiting needs for more expensive conven onal services, lowering cost of treatment, feeling healthier, living with less pain and finding their way to more produc ve lives²⁵. CFO Magazine (targe ng Chief Financial Officers) is urging Fortune 500 companies in the USA to explore cost savings via approaches innovated in the fields of naturopathic medicine, integra ve medicine and other whole-person, health crea ng disciplines²⁶. The findings of the 2010 CHP Group white paper ‘Complementary and Alterna ve Medicine: Integra ng Evidence-based and Cost effec ve ACM into the Health Care System’ states that CAM should be playing a major role in the mitiga on of health care costs and increased quality of care²⁷. The CHP group further states that health plans in the US are increasingly recognising the benefits of CAM care, however the delivery system has yet to maximise the considerable cost, access and quality advantages offered by CAM. These issues are also relevant for Australia.

c Naturopaths are preven on medicine specialists. They understand dis-ease long before there is a diagnosable pathology. Enhancing a primary preven on health model is a significant way to create a healthier society and reduce pressures on the health system. The health system, both the inner and the outer systems, individual and collec ve, has to transform or it will collapse over me²⁸. Preven on does work. The $176 million the Australian government invested in tobacco control over three decades has delivered $8.6 billion in economic returns²⁸.

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The Foundations Project

The Foundations Project is in process codifying the unique knowledge base of naturopathic

medicine, Associate Professor Pam Snider has co-opted 150 contributing naturopathic

writers to publish a rigorous and explicit understanding of naturopathic clinical theory – to

capture the modern interpretation of historical precepts and their place in the era of

evidence based biomedicine²⁹.

Sub-standard training of health professionals in CAM

The public are seeking advice from all kinds of health professionals regarding the use of

complementary and alternative medicine (CAM). These health professionals include but are

not limited to: general practitioners, pharmacists, specialists, physiotherapists, nurses,

osteopaths, chiropractors, massage therapists, psychologists and personal trainers.

Naturopaths are significantly trained in two of the main modalities the public are frequently

seeking information about: herbal medicine as well as nutritional medicine (that includes

vitamins, minerals and other related supplements). Herbal medicine as well as nutritional

medicine require significant in depth training with no less than 4 units of study in each of

these domains. Non-naturopath health professionals working beyond their scope of practice

who offer this advice with limited training in herbal or nutritional medicine are a risk to the

public. The public is at risk going in good faith to health practitioners ‘holding out’ to have

knowledge in these areas. Less than half the medical practitioner community feel

sufficiently knowledgeable about complementary medicine and they receive far less training

and have less knowledge of CAM when compared to CAM therapists¹¹. The public are at risk

when community pharmacists are reporting that less than 15% are confident to answer

queries about safety, interactions or benefits of CAM³⁰. Targeted professional education³¹

for these health professionals is imperative when the safety of the public is at stake.

- Non-naturopath health professionals who have limited training in herbal medicine or

nutritional medicine need to be referring to well trained naturopaths.

- Non-naturopath health professionals need to evidence a minimum training

equivalent to that of a naturopath in both herbal medicine as well as nutritional

medicine if they are holding out in these domains to the public.

Naturopaths because of their broad scope of practice in the various modalities of CAM are

legitimate healthcare providers in this domain.

Negative consequences of removing the rebate Beyond the income consequences for naturopaths who often struggle to maintain their

professional businesses, Australian health consumers will have their choices further

constrained. Those patients who have maintained their private health insurance primarily

to have some partial rebates for CAM via their ‘extras’ cover will be reconsidering whether

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they can afford to continue their private health insurance. Well-informed health consumers

with the target of self-reliant primary health prevention are being ignored or marginalised.

There are many patients who visit a naturopath (often with good outcome) once they have

exhausted all available treatments from conventional and allied health professionals. Are

these health consumers now to be denied a partial rebate from their private health

insurance when they decide to consult a naturopath who offers a different approach to their

care? If so, why?

In addition, there are significant equity concerns. Too often health consumers with limited

financial capacity have negative health outcomes when they are experiencing preventable

early disease symptoms. Removing the rebate may further limit health consumers’ choice in

consulting with health professionals like naturopaths who have significant and legitimate

preventative health expertise.

Conclusion Maintaining health rebates for naturopathy services is fundamental to offering the

Australian public choice in proactive and preventative health care. Evidence is substantial,

both scientific as well as traditional, for the profession of naturopathy. Research both in

Australia and abroad is gathering momentum for naturopathy as a distinct profession with

specific needs in terms of answering the research question that best addresses the complex

approaches used in naturopathic practice. Whole Systems Research is a model that most

closely answers the naturopathy research question. Consequences for consumers as well as

practitioners will be felt if any subsidy is removed to their access and support of efficacious

and evidence-based naturopathic care. Naturopaths are the largest group of unregistered

health professionals in Australia. They are an underutilised workforce engaging in primary

contact health care with millions of Australians. This submission is a justification for the

continued support of health rebates in recognition of the already significant role

naturopaths play in offering patients health support. Australians deserve choice in

healthcare. Naturopathy is only subsidised in a very minimal way via private health

insurance. The public is currently mostly paying out of pocket for naturopathy services. The

prevention and wellness agenda is fundamental to the practice of naturopathy. Naturopaths

can be allies and full team players with other health professionals in offering excellent

health outcomes to consumers. The evidence is there to prove it.

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ANPA Recommendations

Recommendation 1

Maintain and increase the existing financial support for private health

insurance rebates for naturopathy services.

Recommendation 2

Unbundle these naturopathy services as stand-alone services from private

health insurers.

Recommendation 3

Provide significant funding for whole systems research in naturopathy.

Recommendation 4

Table a motion in parliament for the urgent statutory registration of

Naturopaths.

Recommendation 5

Develop competency mapping of educational standards for non-naturopath

health practitioners providing advice to the public in the areas of herbal or

nutritional medicine.

Recommendation 6

Develop clear guidelines for non-naturopath health practitioners to refer to

well trained naturopaths with expertise in CAM.

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Australia. Journal of Clinical Pharmacy and Therapeutics. 2010; 35: 309-321.

Appendix 1Naturopathy: current perspectives

Appendix 1

Integrative MedicineJournal of

Offi cial Journal of the Australasian Integrati ve Medicine Associati on Vol 18 No 3 – December 2012

Naturopathy:Current Perspectives

Where does Chiropractic fit in an Integrated Model of

Healthcare?

Acupuncture and Traditional Chinese

Medicine

Natural Health

Review

Bridging the Gap

Rosehip for Arthritis?

Media Release

Naturopathy is a complete health system off ering many soluti ons for modern health challenges. Naturopathy is oft en misunderstood and misinterpreted. Fundamental principles of naturopathy are described and priority issues of statutory registrati on, educati on standards and cross referrals with other health professionals are highlighted in this arti cle.

What is naturopathy?

Benedict Lust is recognised as the father of naturopathy. He was born in Michelbach Germany in 1872. He moved to New York in 1892, and defined the term naturopathy in 1896.¹ Naturopathy is today

as it was then, a distinct health profession. The practice of naturopathy is underpinned by six foundational principles. These principles are kept in mind when a naturopath takes the case, develops a treatment plan, and supports a client’s ongoing wellness. These six principles are:

• Utilising and harnessing the power of nature – that the body, mind and spirit has the inherent ability and potential to self correct and achieve homeostasis.

• first do no harm – that whatever we suggest or prescribe, whether it be ingestible substances, or a lifestyle or dietary change, are not causing harm.

• find and treat the cause whenever possible – we do not ignore the symptoms, rather, we treat them but are always seeking to identify and treat the underlying driver of the problem(s).

• treat the whole patient – identifying early on what the clients’ beliefs are about their health care, who their support systems are, what matters to them, what their priorities are and how we can align care with who this person is, beyond only referencing their labelled diagnosis.

• education – naturopath as teacher and facilitator fully informs, empowers and guides improved understanding so that the client is more likely to make improved health choices.

• prevention – naturopathy is a different paradigm from conventional medicine. This difference is apparent in how we take a case, identify and understand and treat a dis-ease or functional physiological imbalance long before it becomes a diagnosable pathology. This ability is a true strength of what the paradigm of naturopathy has to offer. We are ‘prevention medicine specialists’.

Naturopathy can offer both complementary and alternative treatment approaches. Complementary treatments are used alongside conventional approaches. Alternative approaches are utilised instead of conventional treatments. Today, there is significant evidence to support both of these approaches.

Current Issues ‘Now let us see the type of men and women who are the naturopaths of today. Many of them are fine, upstanding individuals, believing fully in the effectiveness of their chosen profession – willing to give their all for the sake of alleviating human suffering and ready to fight for their rights to the last ditch. More power to them!’ Benedict Lust, 1945

Lust’s words resonate as strongly today as they did sixty-seven years ago. The challenges for naturopaths in Australia are still aimed at raising our professional profile so that we can take our rightful place amongst the team of health care providers.

Registrati onDetermining accurate numbers of naturopaths continues to be a problem simply because there is no formal register. There could be as many as 10, 000 naturopaths in Australia. This is substantially more than 4000 – the total number of Chinese medicine practitioners registered in 2012.² In 2005, the government commissioned an enquiry into the

Naturopathy: Current Perspectives by Eta Brand B. Naturopathy, BSc.Public Health, Med.TechPresident, ANPA

8 JIM – 2012

‘Practice of Naturopathy and Western Herbal Medicine’ in Australia³. Recommendations from the Lin report³ stated that naturopaths should be a statutorily registered profession.

Statutory registration includes an independent complaints mechanism. In the present self-regulated environment, complaints handling is not independent and can therefore be biased. Since 2005, no further legislation has been approved endorsing the clear recommendation for statutory registration. It must be highlighted that being an unregistered profession does not equate to being an unskilled profession. Naturopaths are a highly skilled workforce and may see as many clients as General Practitioners.4

In 2011, the government proposed a ‘code of conduct’ for the unregistered professions.5 This model of ‘negative licensing’ is inexpensive from the governments’ perspective. Perpetrators are disciplined after the fact, there is no ‘protection of title’ and no minimum education standards are required. This model may be appropriate for many of the unregistered professions but is clearly inadequate in protecting the public from the potential harm that may be caused by naturopaths. Despite submissions made in 2011 arguing for statutory registration for naturopaths, there has been no official response from the government.

Six criteria are specified by the Australian Health Ministers Advisory Council (AHMAC) to be eligible for statutory registration and inclusion under the National Registration and Accreditation Scheme (NRAS). These six criteria can, indeed, be met, however, there seems to be little will on the part of government officials to enact the necessary legislation.

Education

With no statutory registration requiring a national minimum education standard, naturopathy education in Australia is inconsistent. Education providers offer courses ranging from an Advanced Diploma to a Bachelors degree level in Naturopathy. Bachelors degrees may be three years or four years depending on the education provider. Formats of education delivery are inconsistent and it is important to note that many naturopaths have education levels beyond a Bachelor’s degree. Some education providers offer only face-to-face teaching; others offer some distance or online learning in some of the non-skills based subjects and clinical training is on-campus and supervised, while some providers offer only online or distance learning formats with no supervised clinics on campus. These providers have expected students to find external placements with practicing naturopaths. This is unsatisfactory as there is no assessment of the quality of supervision these students will receive externally.

Naturopaths with an Advanced Diploma have been encouraged to upgrade to a Bachelors degree. Some of these upgrades are fraught. The curriculum for the upgrade does not include any topics directly related to naturopathy and as such, these upgrades should be discontinued. The need for a minimum standard starting at a Bachelors level is where the profession of Naturopathy should be aiming. All skill-based competencies should be taught on campus in supervised clinics with approved supervisors. In addition, students should be exposed to external observation in approved practitioners’ clinics as part of their professional training. Absence of minimum standards means students often get caught in the cross fire of paying high amounts for sub-standard training. This has to change.

Adding to the complexity of issues affecting education, some private health insurers have adopted policies that require minimum on-campus supervised clinic hours for naturopaths or they will not rebate their patients. Pauline McCabe6 argued that ‘minimum education standards are unlikely to succeed without the support of a regulatory system that can mandate those minimum requirements.’

“The challenges for naturopaths in Australia are still aimed at raising our

professional profile so that we can take our rightful place amongst the team of

health care providers.”

>>

2012 – JIM 9

ARONAH (Australian Register of Naturopaths and Herbalists)In 2010, the Australian Register of Naturopaths and Herbalists was formed as a first step to being ‘registration ready’. The board has been set up using the National Registration and Accreditation Scheme guidelines for the registered professions. The most recent addition to the scheme under the auspices of Australian Health Professions Regulatory Authority (AHPRA) is Traditional Chinese Medicine. Chinese medicine is a good example with many similarities to the practice of naturopathy recently included in the scheme.

Review of EvidenceGovernment cost cutting measures will be scrutinising the subsidy for rebates on natural therapies paid to the private health insurers. A review has been commissioned to establish the evidence for the practice of naturopathy. This review is to be chaired by the Chief Medical Officer, Prof Baggoley, in 2013. Naturopathy practice is informed and supported by a number of evidence-based published texts. Core modalities of nutritional and herbal medicine have significant evidence that underpins their use. It is of major significance to note that naturopaths use both scientific as well as traditional evidence.

MediaNaturopathy or the modalities that naturopaths use are often highlighted in the media. Unfortunately, the agenda of the media is often to create short-lived sensationalism rather than fully inform their readers. The recent negative agenda of the Friends of Science in Medicine for natural medicines being taught in universities is discriminatory and ill-informed demonstrating an unscientific blinkered perspective to open and rigorous debate. The university campus is the ideal place to interrogate the science where broad gauge academic enquiry can flourish.

Needs of the PublicThe public choice to decide on naturopathic care often requires conventional medical support as well. The scope of practice of naturopaths does not include subsidised pathology testing under Medicare. Naturopaths and their patients need the support of conventionally trained medical practitioners to access these services. Naturopaths can request these tests directly, but the patient then pays an out of pocket expense. This is discriminatory and an important reason why collaboration for the sake of the patient is a priority. To this end, a Memorandum of Understanding (MOU) has been submitted from the ANPA to the AIMA board for review. Seamless respectful cross-referral is the aim. Details of boundaries and how the referral either way needs to occur is an essential requirement for a truly patient-centred approach and team care. Naturopaths want to collaborate for the sake of improved outcomes for their patients. Naturopaths also want recognition that as part of their basic training they have significant knowledge in

the areas of herbal medicine, nutritional medicine and/or homeopathy. This depth of knowledge that naturopaths have in these modalities is a fundamental reason why other health professionals with less training should be referring their patients. In the future, comprehensive competency mapping in these modalities will clarify for various health professions and the public what distinct levels of education are on offer in these modalities.

Naturopathy in Australia has a number of challenges. In the face of those challenges, naturopathy continues to provide the public with enhanced health care choices. Priorities are statutory registration, raising education standards, an independent complaints mechanism and seamless respectful patient-centred cross-referrals with other health professionals. Naturopaths are passionate about keeping the light of naturopathy burning bright. Naturopathy has brought the world a model of healthcare that should be embraced, valued, included and promoted. Naturopathy has the possibility of reducing rising health costs and lowering the disease burden because its fundamental tenet is dis-ease prevention.

BiographyEta Brand B.Naturopathy, BSc Public Health, Med.Tech, ANPA President

References1. Wendel, P. Standardized Naturopathy – The Science and Art of Natural Healing. New York: Wendel; 1951. 2. Grace S. CAM practi ti oners in the Australian health workforce: an underuti lized resource. BMC Complementary

and Alternati ve Medicine 2012, 12:205 3. Lin V, Bensoussan A, Myers S, McCabe P, Cohen M, Hill S, Howse G: The Practi ce and Regulatory Requirements

of Naturopathy and Western Herbal Medicine. Melbourne: Victoria Department of Human Services; 2005. htt p://www.health.vic.gov.au/pracreg/naturopathy.htm

4. Xue C, Zhang A, Lin V, Da Costa C, Story D: Complementary and alternati ve medicine use in Australia: a nati onal populati on-based survey. Journal of Alternati ve and Complementary Medicine 2007,13 (6): 643-50.

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Naturopathy: Current Perspecti ves

“Naturopathy practi ce is informed and supported by a number of evidence-

based published texts. Core modaliti es of nutriti onal and herbal medicine have signifi cant evidence that

underpins their use.”

10 JIM – 2012

Appendix 2 Appendix 2

Evidence table for Naturopathy

Naturopathy Textbook

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studiesExpert opinion

Clinical Efficacyor

Pseudo

1

Galvin, K., & Bishop, M. (2011). Case studies for complementary therapists : A collaborative

approach . Chatswood, N.S.W.: Elsevier Australia.T X X X X X

2

Higdon, J., & Drake, V. G. (2011). An evidence-based approach to vitamins and minerals : Health

benefits and intake recommendations . New York: Thieme.T X X X X

3

Di Carlo, G., Borrelli, F., Ernst, E., & Izzo, A. A. (2001). St John's wort: Prozac from the plant

kingdom. Trends in Pharmacological Sciences, 22 (6), 292-297. X X X X

4

Whiting, P., Bagnall, A. M., Sowden, A. J., Cornell, J. E., Mulrow, C. D., & Ramírez, G. (2001).

Interventions for the treatment and management of chronic fatigue syndrome: A systematic

review. Journal of the American Medical Association, 286 (11), 1360-1368.

X

5

Ernst, E., & Pittler, M. (2000). Efficacy of ginger for nausea and vomiting: a systematic review of

randomized clinical trials. British Journal of Anaesthesia, 84 (3), 367-371. X

6

Hammerness, P., & Basch, E. (2003). St. John's Wort: A systematic review of adverse effects and

drug interactions for the consultation psychiatrist. Psychosomatics, 44 (4), 271-282. X X X X

7

Chinnock JA, Zwickey HL, Connelly E, Calabrese C. Cortisol patterns and DHEA levels of patients with

obesity, prediabetes, and Type 2 Diabetes: A Chart Review in a Naturopathic Primary Care Clinic.

Int J Naturopathic Med 2009 4(1):5-11

X

8

Huntley, A., & Ernst, E. (2000). Herbal medicines for asthma: A systematic review. Thorax, 55 (11),

925-929. X

9

Seely D, Mills EJ, Wu P, Verma S, Guyatt GH. The effects of green tea consumption on incidence of

breast cancer and recurrence of breast cancer: a systematic review and meta-analysis. Integr

Cancer Ther. 2005 Jun;4(2):144-55.

X

10

Prousky J, Seely D. The treatment of migraines and tension-type headaches with intravenous and

oral niacin (nicotinic acid): systematic review of the literature. Nutr J. 2005 Jan 26;4:3.X

11

Gagnier JJ, Chrubasik S, Manheimer E. Harpgophytum procumbens for osteoarthritis and low back

pain: a systematic review. BMC Complement Altern Med . 2004 Sep 15;4:13.X

12

Seely DM, Wu P, Mills EJ. EDTA chelation therapy for cardiovascular disease: a systematic review.

BMC Cardiovasc Disord . 2005 Nov 1;5:32.X

13

Marshall, I. (2006). Zinc for the common cold. Cochrane Database of Systematic Reviews, (3).

Retrieved from doi:10.1002/14651858.CD001364.pub2. X

14

Pittler, M. H., Thompson-Coon, J., & Ernst, E. (2006). Artichoke leaf extract for treating

hypercholesterolaemia. Cochrane Database of Systematic Reviews, (3). Retrieved from

doi:10.1002/14651858.CD003335.pub2

X

ANPA Evidence Table - Naturopathy Jan 2013 - Appendix 2


Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro


15

Poolsup, N., Suthisisang, C., Prathanturarug, S., Asawamekin, A., & Chanchareon, U. (2004).

Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract

infection: Systematic review of randomized controlled trials. Journal of Clinical Pharmacy &

Therapeutics, 29 (1), 37-45. doi: 10.1046/j.1365-2710.2003.00534.x

X

16

Milliman WB, Lamson DW, Brignall MS. Hepatitis C; a retrospective study, literature review, and

naturopathic protocol. Altern Med Rev . 2000 Aug;5(4):355-71.X

17

Thompson Coon, J., & Ernst, E. (2002). Systematic review: Herbal medicinal products for non-ulcer

dyspepsia. Alimentary Pharmacology & Therapeutics, 16 (10), 1689-1699. X

18

Walji R, Weeks L, Cooley K, Seely D. Naturopathic medicine and aboriginal health: an exploratory

study at Anishnawbe Health Toronto. Can J Public Health . 2010 Nov-Dec;101(6):475-80.X

19

Melchart, D., Linde, K., Fisher, P., & Kaesmayr, J. (2003). Echinacea for preventing and treating the

common cold. Cochrane Database of Systematic Reviews, 1 . Retrieved from

doi:10.1002/14651858.CD000530

X X

20

Fetrow, C. W., & Avila, J. R. (2001). Efficacy of the dietary supplement S-adenosyl-L-methionine.

Annals of Pharmacotherapy, 35 (11), 1414-1425. X X

21

De Sanctis, M. T., Belcaro, G., Incandela, L., Cesarone, M. R., Griffin, M., Ippolito, E., & Cacchio, M.

(2001). Treatment of edema and increased capillary filtration in venous hypertension with total

triterpenic fraction of Centella asiatica: A clinical, prospective, placebo-controlled, randomized,

dose-ranging trial. Angiology, 52 (Suppl 2), S55-S59.

X X X X X

22

Flora, K., Hahn, M., Rosen, H., & Benner, K. (1998). Milk thistle (Silybum marianum) for the therapy

of liver disease. American Journal of Gastroenterology, 93 (2), 139-143. X X X X X

23

Fogden, E., & Neuberger, J. (2003). Alternative medicines and the liver. Liver International, 23 (4),

213-220. doi: 10.1034/j.1600-0676.2003.00843.xX X X X

24Fong, H. H. S., & Bauman, J. L. (2002). Hawthorn. Journal of Cardiovascular Nursing, 16 (4), 1-8. X X X

25 Hadley, S., & Petry, J. J. (2003). Valerian. American Family Physician, 67 (8), 1755-1758. X X

26Maizes, V. (2002). Integrative approaches to hypertension. Clinics in Family Practice, 4 (4), 895-910. X X X X

27

Thompson Coon, J. (2004). Evidence for complementary therapies for the treatment of hepatitis C

infection. Focus on Alternative & Complementary Therapies, 9 (1), 7-11. X X X X

28

Douglas, R. M., Chalker, E. B., & Treacy, B. (2004). Vitamin C for preventing and treating the

common cold. Cochrane Database of Systematic Reviews, (1). Retrieved from

doi:10.1002/14651858.CD000980

X X X

29

Fugh-Berman, A. (2000). Herbs and dietary supplements in the prevention and treatment of

cardiovascular disease. Preventive Cardiology, 3 (1), 24-32. X X X X



Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro


30

Györik, S. A., & Brutsche, M. H. (2004). Complementary and alternative medicine for bronchial

asthma: Is there new evidence? Current Opinion in Pulmonary Medicine, 10 (1), 37-43. X X

31

Yazaki Y, Chow G, Mattie M.A single-center, double-blinded, randomized controlled study to

evaluate the relative efficacy of sublingual and oral vitamin B-complex administration in reducing

total serum homocysteine levels. J Altern Complement Med . 2006 Nov;12(9):881-5.

X

32

Hartmann, E. (1983). Effects of L-tryptophan on sleepiness and on sleep. Journal of Psychiatric

Research, 17 (2), 107-113. X

33

Hartz, A. J., Bentler, S., Noyes, R., Hoehns, J., Logemann, C., Sinift, S., . . . Kautzman, H. (2004).

Randomized controlled trial of Siberian ginseng for chronic fatigue. Psychological Medicine, 34 (1),

51-61.

X X X

34

Jorm, A. F., Christensen, H., Griffiths, K. M., & Rodgers, B. (2002). Effectiveness of complementary

and self-help treatments for depression. Medical Journal of Australia, 176 (10), S84-S96. X X X

35

Jorm, A. F., Christensen, H., Griffiths, K. M., & Rodgers, B. (2002). Effectiveness of complementary

and self-help treatments for depression. Medical Journal of Australia, 176 (10), S84-S96. X X X

36

Low Dog, T., & Riley, D. (2003). Management of hyperlipidemia. Alternative Therapies in Health and

Medicine, 9 (3), 28-41. X X

37

Moulds, R. F. W., & Malani, J. (2003). Kava: Herbal panacea or liver poison? Medical Journal of

Australia, 178 (9), 451-453. X X X X X X

38

Nestel, P. (2002b). Cholesterol-lowering with plant sterols. Medical Journal of Australia, 176 (11

Suppl), S122. X

39Pepping, J. (1999a). Melatonin. American Journal of Health-System Pharmacy, 56 (24), 2520-2527. X X X X

40

Pepping, J. (1999b). Omega-3 essential fatty acids. American Journal of Health-System Pharmacy,

56 (8), 719. X X X X

41

Rygwelski, J. M. (2002). Allergic rhinitis: A sampling of complementary therapies. Clinics in Family

Practice, 4 (4), 791-815. X X X X

42

Smith, S. (1998). Tryptophan in the treatment of resistant depression: A review. Pharmaceutical

journal, 261 (7021), 819-821. X X X

43

Calabrese C, Myer S, Munson S, Turet P, Birdsall TC. A cross-over study of the effect of a single oral

feeding of medium chain triglyceride oil vs. canola oil on post-ingestion plasma triglyceride levels in

healthy men. Alternative Medicine Review ; 4(1):23-8, 1999.

X



Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro


44

Surette, M. E., Koumenis, I. L., Edens, M. B., Tramposch, K. M., Clayton, B., Bowton, D., & Chilton, F.

H. (2003). Inhibition of leukotriene biosynthesis by a novel dietary fatty acid formulation in patients

with atopic asthma: a randomized, placebo-controlled, parallel-group, prospective trial. Clinical

Therapeutics, 25 (3), 972-979.

X

45

Weber W, Vander Stoep A, McCarty RL, Weiss NS, Biederman J, McClellan J. Hypericum perforatum

(St John's wort) for attention-deficit/hyperactivity disorder in children and adolescents: a

randomized controlled trial. JAMA . 2008 Jun 11;299(22):2633-41.

X

46

Calabrese C, Gregory WL, Leo M, Kraemer D, Bone K, Oken B. Effects of Bacopa monnieri on

cognitive performance, anxiety and depression in the elderly. J Altern & Comple Med. Jul 2008;

14(6): 707-13.

X

47

Bramwell B, Ferguson S, Scarlett N, Macintosh A. The use of ascorbigen in the treatment of

fibromyalgia patients: a preliminary trial. Altern Med Rev . 2000 Oct;5(5):455-62.X

48

Shinto L, Calabrese C, Morris C, Yadav V, Griffith D, Frank R, Oken BS, Baldauf-Wagner S, Bourdette

D. A randomized pilot study of naturopathic medicine in multiple sclerosis. J Altern Complement

Med. 2008 Jun;14(5):489-96.

X

49

Szczurko O, Cooley K, Busse JW, Seely D, Bernhardt B, Guyatt GH, Zhou Q, Mills EJ. Naturopathic

care for chronic low back pain: a randomized trial. PLoS One. 2007 Sep 19;2(9):e919.X

50

Oberg EB, Bradley RD, Allen J, McCrory MA. CAM: naturopathic dietary interventions for patients

with type 2 diabetes. Complement Ther Clin Pract . 2011 Aug;17(3):157-61. Epub 2011 Mar 17.X

51

Smolinski D, Wollner D, Orlowski J, Curcio J, Nevels J, Kim LS. A pilot study to examine a

combination botanical for the treatment of menopausal symptoms. J Altern Complement Med .

2005 Jun;11(3):483-9.

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52

S Kim L, Hilli L, Orlowski J, Kupperman JL, Baral M, F Waters R. Efficacy of probiotics and nutrients

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53

Szczurko O, Cooley K, Mills EJ, Zhou Q, Perri D, Seely D. Naturopathic treatment of rotator cuff

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Aug 15;61(8):1037-45.

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54

Ritenbaugh C, Hammerschlag R, Calabrese C, Mist S, Aickin M, Sutherland E, Leben J, Debar L, Elder

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Jun;14(5):475-87.

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55

Kim LS, Axelrod LJ, Howard P, Buratovich N, Waters RF. Efficacy of methylsulfonylmethane (MSM)

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Cooley K, Szczurko O, Perri D, Mills EJ, Bernhardt B, Zhou Q, Seely D. Naturopathic care for anxiety:

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Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro


57

Calabrese C, P Preston. Report of the results of a double-blind, randomized, single-dose trial of a

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58

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59

Weber W, Taylor JA, Stoep AV, Weiss NS, Standish LJ, Calabrese C. Echinacea purpurea for

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X

60

Wallman, K. E., Morton, A. R., Goodman, C., Grove, R., & Guilfoyle, A. M. (2004). Randomised

controlled trial of graded exercise in chronic fatigue syndrome. Medical Journal of Australia,

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61Percival, S. S. (2000). Use of echinacea in medicine. Biochemical Pharmacology, 60 (2), 155-158. X X X X

62

Fitzpatrick AL, Standish LJ, Berger J, Kim JG, Calabrese C, Polissar N. Survival in HIV-1 positive adults

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Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro


71

Oberg EB, Bradley RD, Allen J, McCrory MA. CAM: naturopathic dietary interventions for patients

with type 2 diabetes. Complement Ther Clin Pract. 2011 Aug;17(3):157-61. Epub 2011 Mar 17.X

72

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Pseudo RCT

Non-

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Studies

Case control or

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Case series with

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or pre test post

test outcomes

in vivo

animal

studies

in vitro


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Studies

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Pseudo RCT

Non-

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Studies

Case control or

cohort

Case series with

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or pre test post

test outcomes

in vivo

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studies

in vitro


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Non-

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Pseudo RCT

Non-

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Studies

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naturopathic students. Vaccine . 2008 Jul 30.X X

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studies

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Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro


156

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profession. Focus Altern Complement Ther. 2002; 7: 114X

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168


approach (2nd ed.). Philadelphia, PA: Mosby Elsevier.T

169

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Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro


172 Robson, T. (2003). An introduction to complementary medicine . Australia: Allen & Unwin. T X X X X X X X

173

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medicine practice and research in Type 2 Diabetes. Journal of Altern and Complementary Medicine.

2007 159-175.

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perspective. Integ Cancer Therapies. 2009 8 (4) 409-415 X

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of Alternative and Complementary Medicine 2011 17 (12) 1175-1180.X

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2):73-82.

X


Appendix 3

Appendix 3

Evidence table for Herbal Medicine

Herbal MedicineText-

book

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

Clinical Efficacy

1

Liu, J., Manheimer, E., Tsutani, K., & Gluud, C. (2001). Medicinal herbs for hepatitis C

virus infection. Cochrane Database of Systematic Reviews, 4 . doi:

10.1002/14651858.CD003183

X X X X

2

Izzo, A. A., Di Carlo, G., Borrelli, F., & Ernst, E. (2005). Cardiovascular

pharmacotherapy and herbal medicines: The risk of drug interaction. International

Journal of Cardiology, 98 (1), 1-14.

X X X X

3

Miyasaka, L. S., Atallah, Á. N., & Soares, B. (2007). Passiflora for anxiety disorder.

Cochrane Database of Systematic Reviews (1). doi:

10.1002/14651858.CD004518.pub2

X X X X

4

Guo, R., Pittler, M., & Ernst, E. (2008). Hawthorn extract for treating chronic heart

failure. Cochrane Database of Systematic Reviews (1). doi:

10.1002/14651858.CD005312.pub2

X X X X

5deAzevedo Pribitkin, E. (2005). Herbal medicine and surgery. Seminars in Integrative

Medicine, 3 , 17-23. X X X X X X

6

Taylor, R., & Leonard, M. (2010). Curcumin for inflammatory bowel disease: A

review of human studies. Alternative Medicine Review, 16 (2), 152-156. X X X X

7

Di Carlo, G., Borrelli, F., Ernst, E., & Izzo, A. A. (2001). St John's wort: Prozac from the

plant kingdom. Trends in Pharmacological Sciences, 22 (6), 292-297. X X X X

8Sarris, J. (2007). Herbal medicines in the treatment of psychiatric disorders: A

systematic review. Phytotherapy Research, 21 (8), 703-716.X X X X

9

Rahimi, R., Mozaffari, S., & Abdollahi, M. (2009). On the use of herbal medicines in

management of inflammatory bowel diseases: A systematic review of animal and

human studies. Digestive Diseases and Sciences, 54 (3), 471-480.

X X X X X X

10

May, B. H., Lit, M., Xue, C. C. L., Yang, A. W. H., Zhang, A. L., Owens, M. D., et al.

(2009). Herbal medicine for dementia: A systematic review. Phytotherapy Research,

23 (4), 447-459.

X X X X

11

Suksomboon, N., Poolsup, N., Boonkaew, S., & Suthisisang, C. C. (2011). Meta-

analysis of the effect of herbal supplement on glycemic control in type 2 diabetes.

Journal of Ethnopharmacology .

X X X X X

ANPA Evidence Table - Herbal Medicine Jan 2013 - Appendix 3


book

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

12Wald, N. J., & Law, M. R. (2003). A strategy to reduce cardiovascular disease by

more than 80%. BMJ, 326 (7404), 1419.X X X X

13

Franco, O. H., Bonneux, L., De Laet, C., Peeters, A., Steyerberg, E. W., &

Mackenbach, J. P. (2004). The Polymeal: A more natural, safer, and probably tastier

(than the Polypill) strategy to reduce cardiovascular disease by more than 75%.

BMJ, 329 (7480), 1447-1450.

X X X X X

14

Guiotto, P., Woelkart, K., Grabnar, I., Voinovich, D., Perissutti, B., Invernizzi, S., et al.

(2008). Pharmacokinetics and immunomodulatory effects of phytotherapeutic

lozenges (bonbons) with Echinacea purpurea extract. Phytomedicine, 15 (8), 547-

554.

X X X X

15

Chrubasik, J. E., Roufogalis, B. D., Wagner, H., & Chrubasik, S. (2007). A

comprehensive review on the stinging nettle effect and efficacy profiles. Part II:

urticae radix. Phytomedicine, 14 (7), 568-579.

X X X X X

16

Saller, R., Brignoli, R., Melzer, J., & Meier, R. (2008). An updated systematic review

with meta-analysis for the clinical evidence of silymarin. Forschende

Komplementärmedizin/Research in Complementary Medicine, 15 (1), 9-20.

X

17

Schoop, R., Klein, P., Suter, A., & Johnston, S. L. (2006). Echinacea in the prevention

of induced rhinovirus colds: A meta-analysis. Clinical Therapeutics, 28 (2), 174-183.X

18

Leung, K. W., & Wong, A. S. T. (2010). Pharmacology of ginsenosides: A literature

review. Chinese medicine, 5 , 20.X

19

Seely D, Mills EJ, Wu P, Verma S, Guyatt GH. The effects of green tea consumption

on incidence of breast cancer and recurrence of breast cancer: a systematic review

and meta-analysis. Integr Cancer Ther . 2005 Jun;4(2):144-55.

X

20

Ernst, E., & Pittler, M. H. (2000). Efficacy of ginger for nausea and vomiting: A

systematic review of randomized clinical trials. British Journal of Anaesthesia, 84 (3),

367-371.

X

21

Gagnier JJ, Chrubasik S, Manheimer E. Harpgophytum procumbens for osteoarthritis

and low back pain: a systematic review. BMC Complement Altern Med . 2004 Sep

15;4:13.

X

22

Pittler, M. H., & Ernst, E. (2004). Feverfew for preventing migraine. Cochrane

Database of Systematic Reviews, (1). Retrieved from

doi:10.1002/14651858.CD002286.pub2.

X X X



book

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

23Spinella, M. (2001). Herbal medicines and epilepsy: The potential for benefit and

adverse effects. Epilepsy & Behavior, 2 (6), 524-532.X X X X

24

Mentreddy, S. R. (2007). Medicinal plant species with potential antidiabetic

properties. Journal of the Science of Food and Agriculture, 87 (5), 743-750.X X X X

25

Sheng, Y., Li, L., Holmgren, K., & Pero, R. (2001). DNA repair enhancement of

aqueous extracts of Uncaria tomentosa in a human volunteer study. Phytomedicine,

8 (4), 275-282.

X X

26

El-Kamary, S. S., Shardell, M. D., Abdel-Hamid, M., Ismail, S., El-Ateek, M., Metwally,

M., . . . Aboul-Fotouh, A. (2009). A randomized controlled trial to assess the safety

and efficacy of silymarin on symptoms, signs and biomarkers of acute hepatitis.

Phytomedicine , 16(5), 391-400.

X

27

Stough, C., Lloyd, J., Clarke, J., Downey, L. A., Hutchison, C. W., Rodgers, T., &

Nathan, P. J. (2001). The chronic effects of an extract of Bacopa monniera (Brahmi)

on cognitive function in healthy human subjects. Psychopharmacology, 156 (4), 481.

X

28

Schapowal, A. (2002). Randomised controlled trial of butterbur and cetirizine for

treating seasonal allergic rhinitis. BMJ 324 (7330), 144-146. X

29

Schellenberg, R. (2001). Treatment for the premenstrual syndrome with agnus

castus fruit extract: prospective, randomised, placebo-controlled study. British

Medical Journal, 322 (7279), 134-137.

X

30

Morgan, A., & Stevens, J. (2010). Does Bacopa monnieri improve memory

performance in older persons? Results of a randomized, placebo-controlled, double-

blind trial. Journal of Alternative and Complementary Medicine, 16 (7), 753-759.

X

31

Movafegh, A., Alizadeh, R., Hajimohamadi, F., Esfehani, F., & Nejatfar, M. (2008).

Preoperative oral Passiflora incarnata reduces anxiety in ambulatory surgery

patients: A double-blind, placebo-controlled study. Anesthesia & Analgesia, 106 (6),

1728-1732.

X

32

Pommier, P., Gomez, F., Sunyach, M., D'Hombres, A., Carrie, C., & Montbarbon, X.

(2004). Phase III randomized trial of Calendula officinalis compared with trolamine

for the prevention of acute dermatitis during irradiation for breast cancer. Journal

of Clinical Oncology, 22 (8), 1447-1453.

X



book

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

33

Lauritzen, C., Reuter, H., Repges, R., Böhnert, K., & Schmidt, U. (1997). Treatment of

premenstrual tension syndrome with Vitex agnus castus: controlled, double-blind

study versus pyridoxine. Phytomedicine, 4 , 183-189.

X

34

Gallo, M., Sarkar, M., Au, W., Pietrzak, K., Comas, B., Smith, M., et al. (2000).

Pregnancy outcome following gestational exposure to echinacea: A prospective

controlled study. Archives of Internal Medicine, 160 (20), 3141.

X

35

Barton, D. L., Soori, G. S., Bauer, B. A., Sloan, J. A., Johnson, P. A., Figueras, C., et al.

(2010). Pilot study of Panax quinquefolius (American ginseng) to improve cancer-

related fatigue: A randomized, double-blind, dose-finding evaluation: NCCTG trial

N03CA. Supportive Care in Cancer, 18 (2), 179-187.

X

36

Schellenberg, R. (2001). Treatment for the premenstrual syndrome with agnus

castus fruit extract: Prospective, randomised, placebo controlled study. BMJ,

322 (7279), 134-137.

X X

37

Christie, S., Walker, A., Hicks, S., & Abeyasekera, S. (2004). Flavonoid supplement

improves leg health and reduces fluid retention in pre-menopausal women in a

double-blind, placebo-controlled study. Phytomedicine, 11 (1), 11-17.

X

38

Akhondzadeh, S., Noroozian, M., Mohammadi, M., Ohadinia, S., Jamshidi, A., &

Khani, M. (2003a). Melissa officinalis extract in the treatment of patients with mild

to moderate Alzheimer’s disease: A double blind, randomised, placebo controlled

trial. Journal of Neurology, Neurosurgery & Psychiatry, 74 (7), 863-866.

X X

39

Akhondzadeh, S., Noroozian, M., Mohammadi, M., Ohadinia, S., Jamshidi, A., &

Khani, M. (2003b). Salvia officinalis extract in the treatment of patients with mild to

moderate Alzheimer's disease: A double blind, randomized and placebo-controlled

trial. Journal of Clinical Pharmacy and Therapeutics, 28 (1), 53-59.

X X

40

Akhondzadeh, S., Sabet, M. S., Harirchian, M., Togha, M., Cheraghmakani, H.,

Razeghi, S., et al. (2010). Saffron in the treatment of patients with mild to moderate

Alzheimer’s disease: A 16 week, randomized and placebo-controlled trial. Journal of

Clinical Pharmacy and Therapeutics, 35 (5), 581-588.

X X



book

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

41

Gerber, G. S., & Fitzpatrick, J. M. (2004). The role of a lipido-sterolic extract of

Serenoa repens in the management of lower urinary tract symptoms associated with

benign prostatic hyperplasia. BJU International, 94 (3), 338-344.

X

42

Saxena, R., Singh, R., Kumar, P., Yadav, S., Negi, M., Saxena, V., et al. (2010). A

randomized double blind placebo controlled clinical evaluation of extract of

Andrographis paniculata (KalmCold (TM)) in patients with uncomplicated upper

respiratory tract infection. Phytomedicine, 17 (3-4), 178-185.

X

43

Shoba, G., Joy, D., Joseph, T., Majeed, M., Rajendran, R., & Srinivas, P. (1998).

Influence of piperine on the pharmacokinetics of curcumin in animals and human

volunteers. Planta Medica, 64 (4), 353-356.

X

44

Sterk, V., Buechele, B., & Simmet, T. (2004). Effect of food intake on the

bioavailability of boswellic acids from a herbal preparation in healthy volunteers.

Planta Medica, 70 (12), 1155-1160.

X

45

Bone, K. (2003). Phytotherapy thoughts: Reflux demulcents for the chest. Journal of

Complementary Medicine, 2 (3), 68. X X X

46

Stavri, M., Piddock, L. J. V., & Gibbons, S. (2007). Bacterial efflux pump inhibitors

from natural sources. Journal of Antimicrobial Chemotherapy, 59 (6), 1247-1260.X

47

Stermitz, F. R., Lorenz, P., Tawara, J. N., Zenewicz, L. A., & Lewis, K. (2000). Synergy

in a medicinal plant: Antimicrobial action of berberine potentiated by 5′-

methoxyhydnocarpin, a multidrug pump inhibitor. Proceedings of the National

Academy of Sciences, 97 (4), 1433.

X

48

Stoss, M., Michels, C., Peter, E., Beutke, R., & Gorter, R. W. (2000). Prospective

cohort trial of Euphrasia single-dose eye drops in conjunctivitis. Journal of

Alternative and Complementary Medicine, 6 (6), 499-508.

X

49

Altun, M. L., Saltan Çitoğlu, G., Sever Yılmaz, B., & Özbek, H. (2009). Antinociceptive

and anti-inflammatory activities of Viburnum opulus. [Article]. Pharmaceutical

Biology, 47 (7), 653-658.

X

50

Hurrell, R. F., Reddy, M., & Cook, J. D. (1999). Inhibition of non-haem iron

absorption in man by polyphenolic-containing beverages. British Journal of

Nutrition, 81 , 289-295.

X



book

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

51Hughes, D. A. (2005). Plant polyphenols: Modifiers of immune function and risk of

cardiovascular disease. Nutrition, 21 (3), 422-423.X

52

Hopwood, A. (1997). The social construction of illness and its implications for

complementary and alternative medicine. Complementary Therapies in Medicine,

5 (3), 152-155.

X

53Hedley, C., & Coughlin, I. A. (1988). A case from Rivierus. European Journal of Herbal

Medicine, 4 (1), 40-43. X

54

Madhurima, A. S. H., Prawez, A., Sayeed, A., & Md, S. A. (2009). Pharmacognostic

and phytochemical analysis of Gymnema sylvestre R. (Br.) leaves. Journal of Herbal

Medicine and Toxicology, 3 (1), 73-80.

X

55Chavez, M. L., & Chavez, P. I. (1999). Monographs on alternative therapies:

Feverfew. Hospital Pharmacy, 34 (4), 436-461. X

56Trickey, R. (2011). Women, hormones & the menstrual cycle (3rd ed.). Fairfield, Vic.:

Melbourne Holistic Health Group.T X X X X X X

57Mills, S., & Bone, K. (2000). Principles and practice of phytotherapy : Modern herbal

medicine . London: Churchill Livingstone.T X X X X X X X

58Braun, L., & Cohen, M. (2010). Herbs & natural supplements : An evidence-based

guide (3rd ed.). Chatswood, N.S.W.: Elsevier Australia.T X X X X X X X

59

Heinrich, M., Barnes, J., Gibbons, S., & Williamson, E. M. (2012). Fundamentals of

pharmacognosy and phytotherapy (2nd ed.). Edinburgh: Churchill

Livingstone/Elsevier.

T X X X X X

60

Blumenthal, M., Busse, W. R., & German Federal Institute for Drugs and Medical

Devices. (1998). The complete German Commission E monographs: Therapeutic

guide to herbal medicines . Austin, Tex: American Botanical Council

T X X X X

61Bone, K. (2003). A clinical guide to blending liquid herbs : Herbal formulations for

the individual patient . Edinburgh: Churchill Livingstone.T X X X X X

62

Mills, S., & Bone, K. (2000). A systematic approach to herbal prescribing. In S. Mills &

K. Bone (Eds.), Principles and practice of phytotherapy : Modern herbal medicine

(pp. xx, 643 p.). London: Churchill Livingstone.

T X X X

63 Bartram, T. (1998). Bartram's encyclopedia of herbal medicine . New York: Marlowe. T X X X

64 Mills, S. (1993). The essential book of herbal medicine . London ; New York: Arkana. T 2 2 X



book

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

65

Man, S.C., Chan, K.W., Lu, J-H, Kumar Durairajan, S.S., Liu, F-F, Li, M. Systematic

Review on the Efficacy and Safety of Herbal Medicines for Vascular Dementia Evid

Based Complement Alternat Med. 2012; 2012: 426215. Published online 2011

October 20. doi: 10.1155/2012/426215.

X

66

Dos Santos-Neto, L.L., de Vilhena Toledo, M.A., Medeiros-Souza, P & de Souza G.A.

The Use of Herbal Medicine in Alzheimer’s Disease—A Systematic Review. Evidence-

based complementary and alternative medicine : eCAM , ISSN 1741-427X, 12/2006,

Volume 3, Issue 4, pp. 441 – 445.

X

67

Ernst, E., Posadzki, P., & Soo Lee, M. (2011). Complementary and alternative

medicine (CAM) for sexual dysfunction and erectile dysfunction in older men and

women: An overview of systematic reviews. Maturitas, 70(1), 37-41.

X

68

Wanchai, A., Armer, J.M., & Stewart, B.R. (2010). Complementary and Alternative

Medicine Use Among Women With Breast Cancer: A Systematic Review. Clinical

Journal of Oncology Nursing, 14(4),45-55.

X

69

Soeken, K. Selected CAM Therapies for Arthritis-Related Pain: The Evidence From

Systematic Reviews. The Clinical Journal of Pain. 2004 20(1):13-18.X

Cost Effectiveness, Quality & Safety

70

Liu, J., Manheimer, E., Tsutani, K., & Gluud, C. (2001). Medicinal herbs for hepatitis C

virus infection. Cochrane Database of Systematic Reviews, 4 . doi:

10.1002/14651858.CD003183

X X X

71


pharmacotherapy and herbal medicines: The risk of drug interaction. International

Journal of Cardiology, 98 (1), 1-14.

X X X X X X

72

Guo, R., Pittler, M., & Ernst, E. (2008). Hawthorn extract for treating chronic heart

failure. Cochrane Database of Systematic Reviews (1). doi:

10.1002/14651858.CD005312.pub2

X X X X

73

deAzevedo Pribitkin, E. (2005). Herbal medicine and surgery. Seminars in Integrative

Medicine, 3 , 17-23. X X X X X X



book

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

74

Taylor, R., & Leonard, M. (2010). Curcumin for inflammatory bowel disease: A

review of human studies. Alternative Medicine Review, 16 (2), 152-156. X X X X

75

Di Carlo, G., Borrelli, F., Ernst, E., & Izzo, A. A. (2001). St John's wort: Prozac from the

plant kingdom. Trends in Pharmacological Sciences, 22 (6), 292-297. X X X X

76

May, B. H., Lit, M., Xue, C. C. L., Yang, A. W. H., Zhang, A. L., Owens, M. D., et al.

(2009). Herbal medicine for dementia: A systematic review. Phytotherapy Research,

23 (4), 447-459.

X X X X

77

Franco, O. H., Bonneux, L., De Laet, C., Peeters, A., Steyerberg, E. W., &

Mackenbach, J. P. (2004). The Polymeal: A more natural, safer, and probably tastier

(than the Polypill) strategy to reduce cardiovascular disease by more than 75%.

BMJ, 329 (7480), 1447-1450.

X X X X X

78

Guiotto, P., Woelkart, K., Grabnar, I., Voinovich, D., Perissutti, B., Invernizzi, S., et al.

(2008). Pharmacokinetics and immunomodulatory effects of phytotherapeutic

lozenges (bonbons) with Echinacea purpurea extract. Phytomedicine, 15 (8), 547-

554.

X X X X

79 Carter, A. J. (1996). Narcosis and nightshade. BMJ, 313 (7072), 1630-1632. X X X X X

80

Ernst, E. (2002b). The risk–benefit profile of commonly used herbal therapies:

Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava. Annals of

Internal Medicine, 136 (1), 42-53.

X X X X

81

Drew, A. K., & Myers, S. P. (1997). Safety issues in herbal medicine: Implications for

the health professions. Medical Journal of Australia, 166 (10), 538-544.X X X X X

82

Pittler, M. H., & Ernst, E. (2000). Ginkgo biloba extract for the treatment of

intermittent claudication: A meta-analysis of randomized trials. American Journal of

Medicine, 108 (4), 276-281.

X

83

Pittler, M. H., & Ernst, E. (1998). Peppermint oil for irritable bowel syndrome : A

critical review and meta-analysis. American Journal of Gastroenterology, 93 (7), 1131-

1135.

X X X



book

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

84

Melzer, J., Rösch, W., Reichling, J., Brignoli, R., & Saller, R. (2004). Meta-analysis:

Phytotherapy of functional dyspepsia with the herbal drug preparation STW 5

(Iberogast). Alimentary Pharmacology & Therapeutics, 20 (11-12), 1279-1287.

X

85

Saller, R., Brignoli, R., Melzer, J., & Meier, R. (2008). An updated systematic review

with meta-analysis for the clinical evidence of silymarin. Forschende

Komplementärmedizin/Research in Complementary Medicine, 15 (1), 9-20.

X

86

Ernst, E. (2002a). Adulteration of Chinese herbal medicines with synthetic drugs: A

systematic review. Journal of Internal Medicine, 252 (2), 107-113.X X

87

Ernst, E., & Pittler, M. H. (2000). Efficacy of ginger for nausea and vomiting: A

systematic review of randomized clinical trials. British Journal of Anaesthesia, 84 (3),

367-371.

X

88

Henderson, L., Yue, Q. Y., Bergquist, C., Gerden, B., & Arlett, P. (2002). St John's wort

(Hypericum perforatum): Drug interactions and clinical outcomes. British Journal of

Clinical Pharmacology, 54 (4), 349-356.

X X X X

89

Mittman P. Randomized, double-blind study of freeze-dried Urtica dioica in the

treatment of allergic rhinitis. Planta Med. 1990 Feb;56(1):44-7.X

90

Calabrese C, Berman SH, Babish JG, Ma X, Shinto L, Dorr M, Wells K, Wenner CA,

Standish LJ. A phase I trial of andrographolide in HIV positive patients and normal

volunteers. Phytother Res . 2000 Aug;14(5):333-8.

X

91

Heron S, Yarnell E. The safety of low-dose Larrea tridentata (DC) Coville (creosote

bush or chaparral): a retrospective clinical study. J Altern Complement Med . 2001

Apr;7(2):175-85.

X

92

Valli, G., & Giardina, E. G. V. (2002). Benefits, adverse effects and drug interactionsof

herbal therapies with cardiovascular effects. Journal of the American College of

Cardiology, 39 (7), 1083-1095.

X X

93

Herrera-Arellano, A., Flores-Romero, S., Chávez-Soto, M. A., & Tortoriello, J. (2004).

Effectiveness and tolerability of a standardized extract from Hibiscus sabdariffa in

patients with mild to moderate hypertension: A controlled and randomized clinical

trial. Phytomedicine, 11 (5), 375-382.

X



book

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

94

Schmid, B., Kötter, I., & Heide, L. (2001). Pharmacokinetics of salicin after oral

administration of a standardised willow bark extract. European Journal of Clinical

Pharmacology, 57 (5), 387-391.

X X

95

Henderson, L., Yue, Q., Bergquist, C., Gerden, B., & Arlett, P. (2002). St John's wort

(Hypericum perforatum ): Drug interactions and clinical outcomes. British Journal of

Clinical Pharmacology, 54 (4), 349-356.

X X

96

Gallo, M., Sarkar, M., Au, W., Pietrzak, K., Comas, B., Smith, M., et al. (2000).

Pregnancy outcome following gestational exposure to echinacea: A prospective

controlled study. Archives of Internal Medicine, 160 (20), 3141.

X

97

Christie, S., Walker, A., Hicks, S., & Abeyasekera, S. (2004). Flavonoid supplement

improves leg health and reduces fluid retention in pre-menopausal women in a

double-blind, placebo-controlled study. Phytomedicine, 11 (1), 11-17.

X

98Spinella, M. (2001). Herbal medicines and epilepsy: The potential for benefit and

adverse effects. Epilepsy & Behavior, 2 (6), 524-532.X X X X

99


pharmacotherapy and herbal medicines: the risk of drug interaction. International

Journal of Cardiology, 98 (1), 1-14. doi: 10.1016/j.ijcard.2003.06.039

X X

100

Pommier, P., Gomez, F., Sunyach, M., D'Hombres, A., Carrie, C., & Montbarbon, X.

(2004). Phase III randomized trial of Calendula officinalis compared with trolamine

for the prevention of acute dermatitis during irradiation for breast cancer. Journal

of Clinical Oncology, 22 (8), 1447-1453.

X

101

Atmaca, M., Kumru, S., & Tezcan, E. (2003). Fluoxetine versus Vitex Agnus castus

extract in the treatment of premenstrual dysphoric disorder. Human

Psychopharmacology, 18 , 191-195.

X

102

Gerber, G. S., & Fitzpatrick, J. M. (2004). The role of a lipido-sterolic extract of

Serenoa repens in the management of lower urinary tract symptoms associated with

benign prostatic hyperplasia. BJU International, 94 (3), 338-344.

X



book

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

103

El-Kamary, S. S., Shardell, M. D., Abdel-Hamid, M., Ismail, S., El-Ateek, M., Metwally,

M., . . . Aboul-Fotouh, A. (2009). A randomized controlled trial to assess the safety

and efficacy of silymarin on symptoms, signs and biomarkers of acute hepatitis.

Phytomedicine , 16(5), 391-400.

X

104

McRae, S. (1996). Elevated serum digoxin levels in a patient taking digoxin and

Siberian ginseng. CMAJ: Canadian Medical Association Journal, 155 (3), 293.X

105

Stavri, M., Piddock, L. J. V., & Gibbons, S. (2007). Bacterial efflux pump inhibitors

from natural sources. Journal of Antimicrobial Chemotherapy, 59 (6), 1247-1260.X

106

Stermitz, F. R., Lorenz, P., Tawara, J. N., Zenewicz, L. A., & Lewis, K. (2000). Synergy

in a medicinal plant: Antimicrobial action of berberine potentiated by 5′-

methoxyhydnocarpin, a multidrug pump inhibitor. Proceedings of the National

Academy of Sciences, 97 (4), 1433.

X

107

Weber, H. A., Zart, M. K., Hodges, A. E., Molloy, H. M., O'Brien, B. M., Moody, L. A.,

et al. (2003). Chemical comparison of goldenseal (Hydrastis canadensis L.) root

powder from three commercial suppliers. Journal of Agricultural and Food

Chemistry, 51 (25), 7352-7358.

X

108

Rasoanaivo, P., Wright, C. W., Willcox, M. L., & Gilbert, B. (2011). Whole plant

extracts versus single compounds for the treatment of malaria: Synergy and positive

interactions. Malaria Journal, 10 (Suppl 1), S4.

X X

109

Thomas, J. (2003). Potential milk thistle-drug interactions. Australian Journal of

Pharmacy, 84 , 490-491. X X X X

110

Eriksson, J. W., Carlberg, B., & Hillörn, V. (1999). Life-threatening ventricular

tachycardia due to liquorice-induced hypokalaemia. Journal of Internal Medicine,

245 (3), 307-310.

X

111

Kolkhof, P., Geerts, A., Schäfer, S., & Torzewski, J. (2010). Cardiac glycosides potently

inhibit C-reactive protein synthesis in human hepatocytes. Biochemical and

Biophysical Research Communications, 394 (1), 233-239. doi:

10.1016/j.bbrc.2010.02.177

X

112 Bartram, T. (1998). Bartram's encyclopedia of herbal medicine . New York: Marlowe. X X



book

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

113

Zhao, J., Pawar, R. S., Ali, Z., & Khan, I. A. (2007). Phytochemical investigation of

Turnera diffusa. Journal of Natural Products, 70 (2), 289-292. X

114Lambrecht, J., Hamilton, W., & Rabinovich, A. (2000). A review of herb-drug

interactions: Documented and theoretical. US Pharmacist, 25 (8).X

115

Abebe, W. (2002). Herbal medication: Potential for adverse interactions with

analgesic drugs. Journal of Clinical Pharmacy and Therapeutics, 27 (6), 391-401.X

116

Baumeister, A. A., Hawkins, M. F., & Uzelac, S. M. (2003). The myth of reserpine-

induced depression: Role in the historical development of the monoamine

hypothesis. Journal of the History of the Neurosciences, 12 (2), 207-220.

X

117Beecher, G. R. (2003). Overview of dietary flavonoids: Nomenclature, occurrence

and intake. Journal of Nutrition, 133 (10), 3248S-3254S.X

118

Bogusz, M. J., Hassan, H., Al-Enazi, E., Ibrahim, Z., & Al-Tufail, M. (2006). Application

of LC–ESI–MS–MS for detection of synthetic adulterants in herbal remedies. Journal

of Pharmaceutical and Biomedical Analysis, 41 (2), 554-564.

X

119de Pascual-Teresa, S., & Sanchez-Ballesta, M. T. (2008). Anthocyanins: From plant to

health. Phytochemistry reviews, 7 (2), 281-299.X

120

Izzo, A. A., & Ernst, E. (2001). Interactions between herbal medicines and prescribed

drugs: A systematic review. Drugs, 61 (15), 2163-2175.X

121

Heck, A. M., Dewitt, B. A., & Lukes, A. L. (2000). Potential interactions between

alternative therapies and warfarin. American Journal Of Health-System Pharmacy,

57 (13), 1221-1227.

X

122Vickers, A. (1995). Critical appraisal: How to read a clinical research paper.

Complementary Therapies in Medicine, 3 (3), 158-166. X

123

Lin, V., McCabe, P., Bensoussan, A., Myers, S., Cohen, M., Hill, S., & Howse, G.

(2006). The practice and regulatory requirements of naturopathy and western

herbal medicine in Australia . Melbourne, Vic: School of Public Health, La Trobe

University. Retrieved from http://health.vic.gov.au/pracreg/hp-review/naturopathy.

X

124

Wald, A. (2003). Is chronic use of stimulant laxatives harmful to the colon? Journal

of Clinical Gastroenterology, 36 (5), 386.X



book

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RCT or

Pseudo RCT

Non-

experimental

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cohort

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either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

125Trickey, R. (2011). Women, hormones & the menstrual cycle (3rd ed.). Fairfield, Vic.:

Melbourne Holistic Health Group.T X X X X X X

126Mills, S., & Bone, K. (2000). Principles and practice of phytotherapy : Modern herbal

medicine . London: Churchill Livingstone.T X X X X X X X

127Braun, L., & Cohen, M. (2010). Herbs & natural supplements : An evidence-based

guide (3rd ed.). Chatswood, N.S.W.: Elsevier Australia.T X X X X X X X

128

Heinrich, M., Barnes, J., Gibbons, S., & Williamson, E. M. (2012). Fundamentals of

pharmacognosy and phytotherapy (2nd ed.). Edinburgh: Churchill

Livingstone/Elsevier.

T X X X X X

129

Blumenthal, M., Busse, W. R., & German Federal Institute for Drugs and Medical

Devices. (1998). The complete German Commission E monographs: Therapeutic

guide to herbal medicines . Austin, Tex: American Botanical Council

T X X X X

130

Mills, S., & Bone, K. (2000). A systematic approach to herbal prescribing. In S. Mills &

K. Bone (Eds.), Principles and practice of phytotherapy : Modern herbal medicine

(pp. xx, 643 p.). London: Churchill Livingstone.

T X X X

131Bone, K. (2003). A clinical guide to blending liquid herbs : Herbal formulations for

the individual patient . Edinburgh: Churchill Livingstone.T X X X X X

132 Mills, S. (1993). The essential book of herbal medicine . London ; New York: Arkana. T X X X


Appendix 4

Appendix 4

Evidence table for Nutrition

Nutrition Textbook

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

Clinical Efficacy

1

Coppen, A., & Bolander-Gouaille, C. (2005). Treatment of depression: Time to consider

folic acid and vitamin B12. Journal of Psychopharmacology, 19 (1), 59-65. X X X X X

2

Sarris, J., Schoendorfer, N., & Kavanagh, D. J. (2009). Major depressive disorder and

nutritional medicine: A review of monotherapies and adjuvant treatments. Nutrition

Reviews, 67 (3), 125-131.

X X X X

3

Blatt, D. H., Pryor, W. A., Mata, J. E., & Rodriguez-Proteau, R. (2004). Re-evaluation of the

relative potency of synthetic and natural α-tocopherol: Experimental and clinical

observations. Journal of Nutritional Biochemistry, 15 (7), 380-395.

X X X X

4

Mozaffarian, D., Micha, R., & Wallace, S. (2010). Effects on coronary heart disease of

increasing polyunsaturated fat in place of saturated fat: A systematic review and meta-

analysis of randomized controlled trials. PLoS medicine, 7 (3). Retrieved from

doi:10.1371/journal.pmed.1000252

X

5

Geleijnse, J. M., Giltay, E. J., Grobbee, D. E., Donders, A. R. T., & Kok, F. J. (2002). Blood

pressure response to fish oil supplementation: Metaregression analysis of randomized

trials. Journal of Hypertension, 20 (8), 1493.

X

6

Serra-Majem, L., Roman, B., & Estruch, R. (2006). Scientific evidence of interventions

using the Mediterranean diet: A systematic review. Nutrition Reviews, 64 (2), S27-S47. X

7

Hooper, L., Thompson, R. L., Harrison, R. A., Summerbell, C. D., Ness, A. R., Moore, H. J.,

Capps, N. E. (2006). Risks and benefits of omega 3 fats for mortality, cardiovascular

disease, and cancer: systematic review. BMJ, 332 (7544), 752-760.

X X

8

National Heart Foundation of Australia. (2012b). Summary of evidence. Antioxidants in

food, drinks and supplements for cardiovascular health, from

http://www.heartfoundation.org.au/SiteCollectionDocuments/Antioxidants-Summary-

Evidence.pdf

X

9

Micha, R., & Mozaffarian, D. (2010). Saturated fat and cardiometabolic risk factors,

coronary heart disease, stroke, and diabetes: A fresh look at the evidence. Lipids, 45 (10),

893-905.

X

10Boyle, R. J., & Tang, M. L. K. (2006). The role of probiotics in the management of allergic

disease. Clinical and Experimental Allergy 36 , 568-576. X X X X X X

ANPA Evidence Table - Nutrition Jan 2013 - Appendix 4

Nutrition Textbook

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

11

Jusko, T. A., Henderson, C. R. J., Lanphear, B. P., Cory-Slechta, D. A., Parsons, P. J., &

Canfield, R. L. (2008). Blood lead concentrations < 10 mug/dL and child intelligence at 6

years of age. Environmental Health Perspectives, 116 (2), 243-248. Retrieved from

Medscape website: http://www.medscape.com/viewarticle/571058

X X X X X

12

Lenoir-Wijnkoop, I., Sanders, M. E., Cabana, M. D., Caglar, E., Corthier, G., Rayes, N., . . .

Loo, J. V. (2007). Probiotic and prebiotic influence beyond the intestinal tract. Nutrition

Reviews, 65 (11), 469-489.

X X

13

Burger, J., Stern, A. H., & Gochfeld, M. (2005). Mercury in commercial fish: Optimising

individual choices to reduce risk. Environmental Health Perspectives, 113 (3), 266-271. X X X X X

14

Prousky J, Seely D. The treatment of migraines and tension-type headaches with

intravenous and oral niacin (nicotinic acid): systematic review of the literature. Nutr J .

2005 Jan 26;4:3.

X

15

Rabot, S., Rafter, J., Rijkers, G. T., Watzl, B., & Antoine, J. M. (2010). Guidance for

substantiating the evidence for beneficial effects of probiotics: Impact of probiotics on

digestive system metabolism. Journal of Nutrition, 140 (3), 677S-689S.

X X

16

Rock, C. L., Doyle, C., Demark-Wahnefried, W., Meyerhardt, J., Courneya, K. S., Schwartz,

A. L., . . . McCullough, M. (2012). Nutrition and physical activity guidelines for cancer

survivors. CA: A Cancer Journal for Clinicians, 62 (4), 242–274.

X X X X

17

Wandel, S., Jüni, P., Tendal, B., Nüesch, E., Villiger, P. M., Welton, N. J., . . . Trelle, S.

(2010). Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of

hip or knee: Network meta-analysis. BMJ, 341 .

X X X X

18

Block, K. I., Koch, A. C., Mead, M. N., Tothy, P. K., Newman, R. A., & Gyllenhaal, C. (2007).

Impact of antioxidant supplementation on chemotherapeutic efficacy: A systematic

review of the evidence from randomized controlled trials. Cancer Treatment Reviews,

33 (5), 407-418.

X X

19

Wolvers, D., Antoine, J. M., Myllyluoma, E., Schrezenmeir, J., Szajewska, H., & Rijkers, G.

T. (2010). Guidance for substantiating the evidence for beneficial effects of probiotics:

Prevention and management of infections by probiotics. Journal of Nutrition, 140 (3),

698S-712S.

X X

20

Kalliomäki, M., Antoine, J. M., Herz, U., Rijkers, G. T., Wells, J. M., & Mercenier, A. (2010).

Guidance for substantiating the evidence for beneficial effects of probiotics: Prevention

and management of allergic diseases by probiotics. Journal of Nutrition, 140 (3), 713S-

721S.

X X


Nutrition Textbook

Systematic

review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

21

Macfarlane, S., Macfarlane, G., & Cummings, J. H. (2006). Review article: Prebiotics in the

gastrointestinal tract. Alimentary Pharmacology & Therapeutics, 24 (5), 701-714. X X

22

Heart Protection Study Collaborative Group. (2002). MRC/BHF Heart Protection Study of

antioxidant vitamin supplementation in 20 536 high-risk individuals: A randomised

placebo-controlled trial. The Lancet, 360 (9326), 23-33.

X

23

Kris-Etherton, P. M., Yu-Poth, S., Sabaté, J., Ratcliffe, H. E., Zhao, G., & Etherton, T. D.

(1999). Nuts and their bioactive constituents: Effects on serum lipids and other factors

that affect disease risk. American Journal of Clinical Nutrition, 70 (3), S504-S511.

X

24

Liu, R. H. (2003). Health benefits of fruit and vegetables are from additive and synergistic

combinations of phytochemicals. American Journal of Clinical Nutrition , 78(3), 517S-

520S.

X X X X

25

Ames, B. N., McCann, J. C., Stampfer, M. J., & Willett, W. C. (2007). Evidence-based

decision making on micronutrients and chronic disease: Long-term randomized

controlled trials are not enough. American Journal of Clinical Nutrition, 86 (2), 522-523.

X X X

26

Antony, A. C. (2003). Vegetarianism and vitamin B12 (cobalamin) deficiency. American

Journal of Clinical Nutrition, 78 , 3-6. X X X X X

27 Arthur, R. (2007a). Calcium. Journal of Complementary Medicine 6 (2), 46-54. X X X X X

28 Arthur, R. (2007b). Iron. Journal of Complementary Medicine, 6 (3), 36-46. X X X X X

29 Arthur, R. (2007c). Magnesium. Journal of Complementary Medicine 6 (4), 46-54. X X X X X

30 Arthur, R. (2007d). Vitamin D. Journal of Complementary Medicine, 6 (5), 34-40. X X X X X

31 Arthur, R. (2009). Omega-3 sources. Journal of Complementary Medicine, 8 (3), 28-32. X X X X X

32Arthur, R., & Gruner, T. M. (2006). Vitamin C. Journal of Complementary Medicine, 5 (5),

55-62. X X X X X

33Arthur, R., & Gruner, T. M. (2007). Digestion and enzymes. Journal of Complementary

Medicine, 6 (1), 54-59. X X X X X

34

Clegg, D. O., Reda, D. J., Harris, C. L., Klein, M. A., & al., e. (2006). Glucosamine,

chondroitin sulfate, and the two in combination for painful knee osteoarthritis. New

England Journal of Medicine, 359 (8), 795-810.

X X X X X

35

Devine, A., Dick, I. M., Islam, A. F. M., Dhaliwal, S. S., & Prince, R. L. (2005). Protein

consumption is an important predictor of lower limb bone mass in elderly women.

American Journal of Clinical Nutrition, 81 (6), 1423– 1428.

X X X X X


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studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

36

Fraker, P. J., King, L. E., Laakko, T., & Vollmer, T. (2000). The dynamic link between the

integrity of the immune system and zinc status. Journal of Nutrition, 130 (5S), 1399S-

1406S.

X X X X X X

37 Glutathione monograph. (2001). Alternative Medicine Review, 6 (6), 601-607. X X X X

38

Gross, M. D. (2005). Vitamin D and calcium in the prevention of prostate and colon

cancer: New approaches for the identification of needs. Journal of Nutrition, 135 (2), 326-

331.

X X X X X X

39

Calabrese C, Myer S, Munson S, Turet P, Birdsall TC. A cross-over study of the effect of a

single oral feeding of medium chain triglyceride oil vs. canola oil on post-ingestion

plasma triglyceride levels in healthy men. Alternative Medicine Review; 4(1):23-8, 1999.

X

40

Bramwell B, Ferguson S, Scarlett N, Macintosh A. The use of ascorbigen in the treatment

of fibromyalgia patients: a preliminary trial. Altern Med Rev. 2000 Oct;5(5):455-62.X

41

Kajander, K., Myllyluoma, E., Rajilić-Stojanović, M., Kyrönpalo, S., Rasmussen, M.,

Järvenpää, S., . . . Korpela, R. (2008). Clinical trial: Multispecies probiotic supplementation

alleviates the symptoms of irritable bowel syndrome and stabilizes intestinal microbiota.

Alimentary Pharmacology & Therapeutics, 27 (1), 48-57.

X X

42Rayman, M. P. (2000). The importance of selenium to human health. The Lancet 356 ,

233-241. X X X X X X

43

Reginster, J.-Y. (2005). The high prevalence of inadequate serum vitamin D levels and

implications for bone health. Current Medical Research Opinion 21 (4), 579-585. X X X X X

44

Selenium: Does selenium status have health outcomes beyond overt deficiency? (2004).

[Editorial ]. Medical Journal of Australia, 180 , 373-374. X X X X

45

Wintergerst, E. S., Maggini, S., & Hornig, D. H. (2007). Contribution of selected vitamins

and trace elements to immune function. Annals of Nutrition and Metabolism, 51 (4), 301-

323.

X X X X X X

46

Daniele, B., Perrone, F., Gallo, C., Pignata, S., De Martino, S., De Vivo, R., . . . D'Agostino,

L. (2001). Oral glutamine in the prevention of fluorouracil induced intestinal toxicity: A

double blind, placebo controlled, randomised trial. Gut, 48 (1), 28-33.

X X

47

Stephens, N. G., & Parsons, A. (1996). Randomised controlled trial of vitamin E in patients

with coronary disease: Cambridge Heart. The Lancet, 347 (9004), 781. X


Nutrition Textbook

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studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

48

Tran, M. T., Mitchell, T. M., Kennedy, D. T., & Giles, J. T. (2001). Role of coenzyme Q10 in

chronic heart failure, angina, and hypertension. Pharmacotherapy, 21 (7), 797-806. X X X X

49

Van Duyn, M. S., & Pivonka, E. (2000). Overview of the health benefits of fruit and

vegetable consumption for the dietetics professional:: Selected literature. Journal of the

American Dietetic Association, 100 (12), 1511-1521.

X X

50 Natoli, S. (2006). Coffee. Journal of Complementary Medicine, 5 (3), 77. X X X

51

Bruno, R. S., & Traber, M. G. (2005). Cigarette smoke alters human vitamin E

requirements. The Journal of Nutrition, 135 (4), 671-674. X X X

52

Chia, A. L. K., Shumack, S., & Foley, P. (2005). Vitamin D and adult bone health in

Australia and New Zealand: A position statement. Medical Journal of Australia, 182 (1),

281-285.

X X

53

van Dam, R. M., Willett, W. C., Rimm, E. B., Stampfer, M. J., & Hu, F. B. (2002). Dietary fat

and meat intake in relation to risk of type 2 diabetes in men. Diabetes Care, 25 (3), 417-

424.

X

54

Norat, T., Bingham, S., Ferrari, P., Slimani, N., Jenab, M., Mazuir, M., . . . Clavel, F. (2005).

Meat, fish, and colorectal cancer risk: The European Prospective Investigation into cancer

and nutrition. Journal of the National Cancer Institute, 97 (12), 906-916.

X

55

Elwood, P., Pickering, J., Hughes, J., Fehily, A., & Ness, A. (2004). Milk drinking, ischaemic

heart disease and ischaemic stroke II. Evidence from cohort studies. European Journal of

Clinical Nutrition, 58 (5), 718-724.

X

56

Tapsell, L. C., Brenninger, V., & Barnard, J. (2000). Applying conversation analysis to

foster accurate reporting in the diet history interview. Journal of the American Dietetic

Association, 100 (7), 818-824.

X X

57

Craig, W., & Mangels, A. (2009). Position of the American Dietetic Association: Vegetarian

diets. Journal of the American Dietetic Association, 109 (7), 1266. X

58

Bruno, R. S., Leonard, S. W., Atkinson, J., Montine, T. J., Ramakrishnan, R., Bray, T. M., &

Traber, M. G. (2006). Faster plasma vitamin E disappearance in smokers is normalized by

vitamin C supplementation. Free Radical Biology & Medicine, 40 (4), 689-697.

X X X X

59

Li, M., Eastman, C. J., Waite, K. V., Ma, G., Zacharin, M. R., Topliss, D. J., . . . Mortimer, R.

H. (2006). Are Australian children iodine deficient? Results of the Australian National

Iodine Nutrition Study. Medical Journal of Australia, 184 (4), 165.

X X


Nutrition Textbook

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level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

60

Schrager, S. (2005). Dietary calcium intake and obesity. Journal of the American Board of

Family Practice, 18 (3), 205-210. X

61

Andrews, C., & Morgan, M. (2005). Nutrients & herbs for longevity & disease prevention:

Vitamin C, alpha lipoic acid & resveratrol. MH Advance Nutritional Perspective . X X X X

62

Blom, H., Jacobs, C., Fowler, B., & Koch, H. G. (1998). Disorders of homocysteine

metabolism – from rare genetic defects to common risk factors. European Journal of

Pediatrics, 157 (Suppl 2), S39.

X X X X

63

Chertow, B. (2004). Advances in diabetes for the millennium: Vitamins and oxidant stress

in diabetes and Its complications. Medscape General Medicine, 6 (3s). X X X X

64

Finkelstein, J. D. (1998). The metabolism of homocysteine: Pathways and regulation.

European Journal of Pediatrics, 157 (Suppl 2), S40-S44. X X X X

65

Ionescu, G., Kiehl, R., Wichmann-Kunz, F., Williams, C., Bäuml, L., & Levine, S. (1990). Oral

citrus seed extract in atopic eczema: In vitro and in vivo studies on intestinal microflora.

Journal of Orthomolecular Medicine, 5 (3), 155-157.

X X X

66

Mann, J., & Aitken, E. (2003). The re-emergence of iodine deficiency in New Zealand?

New Zealand Medical Journal, 116 (1170), 1-5. X X X

67

Morris, M. C. (2004). Diet and Alzheimer’s disease: What the evidence shows. Medscape

General Medicine, 6 (1). Retrieved from Medscape website:

http://www.medscape.com/viewarticle/466037

X X X X

68

Guha, N., Kwan, M. L., Quesenberry, C. P., Weltzien, E. K., Castillo, A. L., & Caan, B. J.

(2009). Soy isoflavones and risk of cancer recurrence in a cohort of breast cancer

survivors: The Life After Cancer Epidemiology study. Breast Cancer Research and

Treatment, 118 (2), 395-405.

X X

69

Pantuck, A. J., Leppert, J. T., Zomorodian, N., Aronson, W., Hong, J., Barnard, R. J., . . .

Elashoff, R. (2006). Phase II study of pomegranate juice for men with rising prostate-

specific antigen following surgery or radiation for prostate cancer. Clinical Cancer

Research, 12 (13), 4018-4026.

X X

70

Salonen, R. M., Nyyssönen, K., Kaikkonen, J., Porkkala-Sarataho, E., Voutilainen, S.,

Rissanen, T. H., . . . Poulsen, H. E. (2003). Six-year effect of combined vitamin C and E

supplementation on atherosclerotic progression: The Antioxidant Supplementation in

Atherosclerosis Prevention (ASAP) Study. Circulation, 107 (7), 947-953.

X


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studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

71

Sinclair, A., & Dunstan, G. A. (1993). The lipid content and fatty acid composition of

commercial marine and freshwater fish and molluscs from temperate waters. Journal of

the American Dietetic Association, 93 (5), 600.

X

72

Pepping, J. (1999c). Phosphatidylserine. American Journal of Health-System Pharmacy,

56 (20), 2038. X

73

Pepping, J. (2003). Policosanol. American Journal of Health-System Pharmacy, 60 (11),

1112-1115. X

74

Hargreaves, I. P., Duncan, A. J., Heales, S. J. R., & Land, J. M. (2005). The effect of HMG-

CoA reductase inhibitors on coenzyme Q10: Possible biochemical/clinical implications.

Drug Safety, 28 (8), 659-676.

X

75

Burks, A. (2009). Early peanut consumption: Postpone or promote? Journal of Allergy

and Clinical Immunology, 123 (2), 424-425. X

76

Costa, N. D. (2007). Reducing the meat and livestock industry's environmental footprint.

Nutrition & Dietetics, 64 (Suppl. 4), S185-S191. X

77

Clarke, L., McQueen, J., Smild, A., & Swain, A. (1996). Dietitians Association of Australia

review paper: The dietary management of food allergy and food intolerance in children

and adults. Australian Journal of Nutrition and Dietetics, 53 , 89-98.

X

78

Barrett, J. S., & GIbson, P. R. (2007). Clinical ramifications of malabsorption of fructose

and other short-chain carbohydrates. Practical Gastroenterology, 31 (8), 51. X

79

Atkinson, F. S., Foster-Powell, K., & Brand-Miller, J. C. (2008). International tables of

glycemic index and glycemic load values: 2008. Diabetes Care, 31 (12), 2281-2283. X

80

Frost, G., & Dornhorst, A. (2000). The relevance of the glycaemic index to our

understanding of dietary carbohydrates. Diabetic medicine, 17 (5), 336-345. X

81

Hawrelak, J. A., & Myers, S. P. (2004). The causes of intestinal dysbiosis: A review.

Alternative Medicine Review, 9 (2), 180. X

82

Sobal, J. (2008). Sociological analysis of the stigmatisation of obesity. In J. Germov & L.

Williams (Eds.), A sociology of food and nutrition : The social appetite (3rd ed., pp. xvi,

425 p.). South Melbourne, Vic.: Oxford University Press.

X

83Higdon, J. (2007). An evidence-based approach to dietary phytochemicals . New York:

Thieme Medical Publishers.T X X X


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studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

84

Oslecki, H. (2006). The physician's handbook of clinical nutrition (7th ed.). Eagle Farm,

Qld.: Bioconcepts Publishing.T X X X X X X

85

Wanchai, A., Armer, J.M, Stewart, B.R. (2010) Complementary and Alternative Medicine

Use Among Women With Breast Cancer: A Systematic Review. Clinical Journal of

Oncology Nursing , 14(4), 45-55.

X

Cost Effectiveness

86Pimentel, D., & Pimentel, M. (2003). Sustainability of meat-based and plant-based diets

and the environment. American Journal of Clinical Nutrition, 78 (3), S660-S663. X

87Thomason, D. (2007). Production practices for red meat in Australia. Nutrition &

Dietetics, 64 (Suppl. 4), S192-S195. X

88

Keller, J. L., Lanou, A. J., & Barnard, N. D. (2002). The consumer cost of calcium from food

and supplements. Journal of the American Dietetic Association, 102 (11), 1669-1671. X

Quality & Safety

89

Sarris, J., Schoendorfer, N., & Kavanagh, D. J. (2009). Major depressive disorder and

nutritional medicine: A review of monotherapies and adjuvant treatments. Nutrition

Reviews, 67 (3), 125-131.

X X X X

90

Patisaul, H. B., & Jefferson, W. (2010). The pros and cons of phytoestrogens. Frontiers in

neuroendocrinology, 31 (4), 400-419.X X X X X X X

91

Wandel, S., Jüni, P., Tendal, B., Nüesch, E., Villiger, P. M., Welton, N. J., . . . Trelle, S.

(2010). Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of

hip or knee: Network meta-analysis. BMJ, 341 .

X X X X

92

DeFilippis, A. P., & Sperling, L. S. (2006). Understanding omega-3’s. American Heart

Journal, 151 (3), 564-570. X X X X X

93

National Heart Foundation of Australia. (2012b). Summary of evidence. Antioxidants in

food, drinks and supplements for cardiovascular health, from

http://www.heartfoundation.org.au/SiteCollectionDocuments/Antioxidants-Summary-

Evidence.pdf

X


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review of

level II

studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series with

either post test

or pre test post

test outcomes

in vivo

animal

studies

in vitro

studies

Expert

opinion

94

Block, K. I., Koch, A. C., Mead, M. N., Tothy, P. K., Newman, R. A., & Gyllenhaal, C. (2007).

Impact of antioxidant supplementation on chemotherapeutic efficacy: A systematic

review of the evidence from randomized controlled trials. Cancer Treatment Reviews,

33 (5), 407-418.

X X

95

Mills E, Prousky J, Raskin G, Gagnier J, Rachlis B, Montori VM, Juurlink D. The safety of

over-the-counter niacin. A randomized placebo-controlled trial [ISRCTN18054903]. BMC

Clin Pharmacol . 2003 Nov 13;3:4.

X

96

Ames, B. N., McCann, J. C., Stampfer, M. J., & Willett, W. C. (2007). Evidence-based

decision making on micronutrients and chronic disease: Long-term randomized

controlled trials are not enough. American Journal of Clinical Nutrition, 86 (2), 522-523.

X X X

97Jones, K., Hughes, K., Mischley, L., & McKenna, D. J. (2002). Coenzyme Q10: Efficacy,

safety, and use. Alternative Therapies, 8 (3), 42-56. X X X X X

98

Chertow, B. (2004). Advances in diabetes for the millennium: Vitamins and oxidant stress

in diabetes and Its complications. Medscape General Medicine, 6 (3s). X X X X

99

Olsson, I.-M., Eriksson, J., Öborn, I., Skerfving, S., & Oskarsson, A. (2005). Cadmium in

food production systems: A health risk for sensitive population group. Ambio, 34 (4/5),

344-351.

X X X X

100

Yan, L., & Spitznagel, E. L. (2009). Soy consumption and prostate cancer risk in men: A

revisit of a meta-analysis. American Journal of Clinical Nutrition, 89 (4), 1155-1163. X X X

101Jarup, L. (2003). Hazards of heavy metal contamination. British Medical Bulletin, 68 (1),

167-183. X

102

Agte, V., Tarwadi, K., Mengale, S., Hinge, A., & Chiplonkar, S. (2002). Vitamin profile of

cooked foods: How healthy is the practice of ready-to-eat foods? International Journal of

Food Sciences and Nutrition 53 , 197-208.

X

103

Webb, G. P. (2008). Methods of nutritional surveillance and research: Methods used to

establish links between diet and disease. In G. P. Webb (Ed.), Nutrition : a health

promotion approach (3rd ed., pp. 97-122). London: Hodder Arnold.

T


Appendix 5

Appendix 5

Evidence table for Tactile Therapies

Tactile Therapies Textbook

Systematic

review of level

II studies

Experimental

Studies

RCT or Pseudo

RCT

Non-

experimental

Studies

Case control or

cohort

Case series

with either

post test or

pre test post

test outcomes

in vivo

animal

studies

in vitro


Clinical Efficacy

1

Fellowes, D., Barnes, K., & Wilkinson, S. S. (2008). Aromatherapy and massage for symptom relief

in patients with cancer. Cochrane Database Of Systematic Reviews (4). doi:

10.1002/14651858.CD002287.pub3

X X

2

Preston, N., Seers, K., & Mortimer, P. (2004). Physical therapies for reducing and controlling

lymphoedema of the limbs. Cochrane Database of Systematic Reviews, (4). Retrieved from

doi:10.1002/14651858.CD003141.pub2

X X

3

Vairo, G. L., Miller, S. J., McBrier, N. M., & Buckley, W. E. (2009). Systematic review of efficacy for

manual lymphatic drainage techniques in sports medicine and rehabilitation: An evidence-based

practice approach. Journal of Manual & Manipulative Therapy, 17 (3), e80.

X X

4

Ezzo, J., Haraldsson, B. G., Gross, A. R., Myers, C. D., Morien, A., Goldsmith, C. H., . . . Peloso, P. M.

(2007). Massage for mechanical neck disorders: A systematic review. Spine, 32 (3), 353. X X

5

Moyer, C. A., Rounds, J., & Hannum, J. W. (2004). A meta-analysis of massage therapy research.

Psychological Bulletin, 130 (1), 3. X

6

Brosseau, L., Casimiro, L., Milne, S., Robinson, V., Shea, B., Tugwell, P., & Wells, G. (2002). Deep

transverse friction massage for treating tendinitis. Cochrane Database Of Systematic Reviews (4).

doi: 10.1002/14651858.CD003528

X X

7

Ernst, E. (1999a). Abdominal massage therapy for chronic constipation: A systematic review of

controlled clinical trials. Forschende Komplementärmedizin/Research in Complementary Medicine,

6 (3), 149-151.

X

8

Marine, A., Ruotsalainen, J., Serra, C., & Verbeek, J. (2006). Preventing occupational stress in

healthcare workers. Cochrane Database Of Systematic Reviews (4). doi:

10.1002/14651858.CD002892.pub2

X X

9

Ellis, R., Hing, W., & Reid, D. (2007). Iliotibial band friction syndrome—A systematic review.

Manual Therapy, 12 (3), 200-208. X X

10

Ernst, E. (1999b). Massage therapy for low back pain: A systematic review. Journal of Pain and

Symptom Management, 17 (1), 65-69. X X

11

Robinson, J., Biley, F. C., & Dolk, H. (2007). Therapeutic touch for anxiety disorders. Cochrane

Database Of Systematic Reviews (3). doi: 10.1002/14651858.CD006240.pub2X X

12

Russell, N. C., Sumler, S. S., Beinhorn, C. M., & Frenkel, M. A. (2008). Role of massage therapy in

cancer care. Journal of Alternative and Complementary Medicine, 14 (2), 209-214. X X

13 Cox, C. (2003). Remedial massage. Journal of Complementary Medicine, 2 (1), 24. X

ANPA Evidence Table - Tactile Therapies Jan 2013 - Appendix 5


Systematic

review of level

II studies

Experimental

Studies

RCT or Pseudo

RCT

Non-

experimental

Studies

Case control or

cohort

Case series

with either

post test or

pre test post

test outcomes

in vivo

animal

studies

in vitro


14 Manheim, C. J. (2008). The myofascial release manual (4th ed.). Thorofare, NJ: SLACK. T X X X X

15

Ward, R. C. (2002). Foundations for osteopathic medicine (2nd ed.). Philadelphia: Lippincott

Williams & Wilkins.T X X X X

16Chaitow, L. (2007). Positional release techniques (3rd ed.). Edinburgh: Churchill Livingstone. T X X X X

17

D'Ambrogio, K. J., & Roth, G. B. (1997). Positional release therapy : Assessment & treatment of

musculoskeletal dysfunction . St. Louis: Mosby.T X X X X

18

Myers, T. W. (2001). Anatomy trains : Myofascial meridians for manual and movement therapists.

Edinburgh ; New York: Churchill Livingstone.T X X X X

19

Kisner, C., & Colby, L. A. (2012). Therapeutic exercise : Foundations and techniques (6th ed.).

Philadelphia: F.A. Davis.T X X X X

20 Rolf, I. P. (1978). Rolfing : The integration of human structures . New York: Harper & Row. T X X X X

21

Simons, D. G., Travell, J. G., & Simons, L. S. (1999). Travell & Simons' myofascial pain and

dysfunction : The trigger point manual (2nd ed.). Philadelphia, PA: Lippincott Williams & Wilkins.T X X X X

22

Fritz, S. (2012). Mosby's fundamentals of therapeutic massage (5th ed.). Maryland Heights, Mo.:

Mosby.T X X X X

23

Clay, J. H., & Pounds, D. M. (2008). Basic clinical massage therapy : Integrating anatomy and

treatment (2nd ed.). London: Lippincott Williams and Wilkins.T X X X

24

Casanelia, L., Stelfox, D. P., & Tuchtan, C. C. (2010). Foundations of massage (3rd ed.). Sydney:

Churchill Livingstone Elsevier.T X X X

25

Andrade, C.-K., & Clifford, P. (2008). Outcome-based massage : From evidence to practice (2nd

ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.T X X X

26

Sinclair, M. (2007). Modern hydrotherapy for the massage therapist. Philadelphia: Lippincott

Williams & Wilkins.T X X

Cost Effectiveness, Quality & Safety

27

Fellowes, D., Barnes, K., & Wilkinson, S. S. (2008). Aromatherapy and massage for symptom relief

in patients with cancer. Cochrane Database Of Systematic Reviews (4). doi:

10.1002/14651858.CD002287.pub3

X X

28

Ernst, E. (1999b). Massage therapy for low back pain: A systematic review. Journal of Pain and

Symptom Management, 17 (1), 65-69. X X



Systematic

review of level

II studies

Experimental

Studies

RCT or Pseudo

RCT

Non-

experimental

Studies

Case control or

cohort

Case series

with either

post test or

pre test post

test outcomes

in vivo

animal

studies

in vitro


29

Brosseau, L., Casimiro, L., Milne, S., Robinson, V., Shea, B., Tugwell, P., & Wells, G. (2002). Deep

transverse friction massage for treating tendinitis. Cochrane Database Of Systematic Reviews (4).

doi: 10.1002/14651858.CD003528

X X

30

Vairo, G. L., Miller, S. J., McBrier, N. M., & Buckley, W. E. (2009). Systematic review of efficacy for

manual lymphatic drainage techniques in sports medicine and rehabilitation: An evidence-based

practice approach. Journal of Manual & Manipulative Therapy, 17 (3), e80.

X X

31

Preston, N., Seers, K., & Mortimer, P. (2004). Physical therapies for reducing and controlling

lymphoedema of the limbs. Cochrane Database of Systematic Reviews, (4). Retrieved from

doi:10.1002/14651858.CD003141.pub2

X X

32

Ezzo, J., Haraldsson, B. G., Gross, A. R., Myers, C. D., Morien, A., Goldsmith, C. H., . . . Peloso, P. M.

(2007). Massage for mechanical neck disorders: A systematic review. Spine, 32 (3), 353. X X

33

Moyer, C. A., Rounds, J., & Hannum, J. W. (2004). A meta-analysis of massage therapy research.

Psychological Bulletin, 130 (1), 3. X

34

Ernst, E. (1999a). Abdominal massage therapy for chronic constipation: A systematic review of

controlled clinical trials. Forschende Komplementärmedizin/Research in Complementary Medicine,

6 (3), 149-151.

X

35

Ernst, E., Pittler, M., Wider, B., & Boddy, K. (2007). Massage therapy: Is its evidence-base getting

stronger. Complementary Health Practice Review, 12 (3), 179-183. X X

36

Russell, N. C., Sumler, S. S., Beinhorn, C. M., & Frenkel, M. A. (2008). Role of massage therapy in

cancer care. Journal of Alternative and Complementary Medicine, 14 (2), 209-214. X 3

37

Fritz, S. (2012). Mosby's fundamentals of therapeutic massage (5th ed.). Maryland Heights, Mo.:

Mosby.T X X X X

38 Manheim, C. J. (2008). The myofascial release manual (4th ed.). Thorofare, NJ: SLACK. T X X X X

39

Ward, R. C. (2002). Foundations for osteopathic medicine (2nd ed.). Philadelphia: Lippincott

Williams & Wilkins.T X X X X

40Chaitow, L. (2007). Positional release techniques (3rd ed.). Edinburgh: Churchill Livingstone. T X X X X

41

D'Ambrogio, K. J., & Roth, G. B. (1997). Positional release therapy : Assessment & treatment of

musculoskeletal dysfunction . St. Louis: Mosby.T X X X X

42

Myers, T. W. (2001). Anatomy trains : Myofascial meridians for manual and movement therapists.

Edinburgh ; New York: Churchill Livingstone.T X X X X



Systematic

review of level

II studies

Experimental

Studies

RCT or Pseudo

RCT

Non-

experimental

Studies

Case control or

cohort

Case series

with either

post test or

pre test post

test outcomes

in vivo

animal

studies

in vitro


43

Kisner, C., & Colby, L. A. (2012). Therapeutic exercise : Foundations and techniques (6th ed.).

Philadelphia: F.A. Davis.T X X X X

44 Rolf, I. P. (1978). Rolfing : The integration of human structures . New York: Harper & Row. T X X X X

45

Simons, D. G., Travell, J. G., & Simons, L. S. (1999). Travell & Simons' myofascial pain and

dysfunction : The trigger point manual (2nd ed.). Philadelphia, PA: Lippincott Williams & Wilkins.T X X X X


Appendix 6

Appendix 6

Evidence table for Homoeopathy

Homoeopathy Textbook

Systematic

review of level

II studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series

with either

post test or

pre test post

test outcomes

in vivo

animal

studies

in vitro


Clinical Efficacy

1Altunç, U., Pittler, M. H., & Ernst, E. (2007). Homeopathy for childhood and adolescence ailments:

Systematic review of randomized clinical trials. Mayo Clinic Proceedings: Mayo Clinic, 82 (1), 69-75. X

2

Vickers, A., & Smith, C. (2009). Withdrawn: Homoeopathic Oscillococcinum for preventing and

treating influenza and influenza-like syndromes. Cochrane Database Of Systematic Reviews

(Online) (3), CD001957.

X X

3

Jacobs, J., Jiménez, L. M., Malthouse, S., Chapman, E., Crothers, D., Masuk, M., & Jonas, W. B.

(2000). Homeopathic treatment of acute childhood diarrhea: Results from a clinical trial in Nepal.

Journal of Alternative and Complementary Medicine , 6(2), 131-139.

X

4Mousavi, F., Mojaver, Y. N., Asadzadeh, M., & Mirzazadeh, M. (2009). Homeopathic treatment of

minor aphthous ulcer: A randomized, placebo-controlled clinical trial. Homeopathy, 98 (3), 137. X

5

Piltan, D., Rist, L., Simões-Wüst, P., & Saller, R. (2009). Test of a homeopathic dilution of Aconitum

napellus. A clinical, randomized, double-blind, controlled crossover study in healthy volunteers.

Forschende Komplementärmedizin/Research in Complementary Medicine, 16(3), 168-173.

X

6

Walach, H., Hennig, T., & Haag, G. (2001). The effects of homeopathic belladonna 30CH in healthy

volunteers: A randomized, double-blind experiment. Journal of Psychosomatic Research, 50 (3), 155-

160.

X

7Chand, S. K., Manchanda, R., Batra, S., & Mittal, R. (2011). Homeopathy in the treatment of

tubercular lymphadenitis (TBLN)-An Indian experience. Homeopathy, 100 (3), 157-167. X

8

Frass, M., Linkesch, M., Banyai, S., Resch, G., Dielacher, C., Löbl, T., . . . Schuster, E. (2005).

Adjunctive homeopathic treatment in patients with severe sepsis: A randomized, double-blind,

placebo-controlled trial in an intensive care unit. Homeopathy, 94 (2), 75-80.

X

9

Thompson, E., Shaw, A., Nichol, J., Hollinghurst, S., Henderson, A., Thompson, T., & Sharp, D.

(2011). The feasibility of a pragmatic randomised controlled trial to compare usual care with usual

care plus individualised homeopathy, in children requiring secondary care for asthma.

Homeopathy, 100 (3), 122-130.

X X

10

Taylor, M. A., Reilly, D., Llewellyn-Jones, R. H., McSharry, C., & Aitchison, T. C. (2000). Randomised

controlled trial of homeopathy versus placebo in perennial allergic rhinitis with overview of four

trial series. BMJ, 321 (7259), 471-476. doi: 10.1136/bmj.321.7259.471

X

11

Spin-Neto, R., Belluci, M. M., Sakakura, C. E., Scaf, G., Pepato, M. T., & Marcantonio Jr, E. (2010).

Homeopathic Symphytum officinale increases removal torque and radiographic bone density

around titanium implants in rats. Homeopathy, 99 (4), 249-254.

X

ANPA Evidence Table - Homeophathy Jan 2013 - Appendix 6


Systematic

review of level

II studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series

with either

post test or

pre test post

test outcomes

in vivo

animal

studies

in vitro


12

Shang, A., Huwiler-Müntener, K., Nartey, L., Jüni, P., Dörig, S., Sterne, J. A. C., . . . Egger, M. (2005).

Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled

trials of homoeopathy and allopathy. The Lancet, 366 (9487), 726-732.

X

13Kistin, S. J., & Newman, A. D. (2007). Induction of labor with homeopathy: A case report. Journal of

Midwifery & Women's Health, 52 (3), 303-307. X

14Adler, U. (2005). The influence of childhood infections and vaccination on the development of

atopy: A systematic review of the direct epidemiological evidence. Homeopathy, 94 (3), 182-195. X X

15

Du, Y., & Knopf, H. (2009). Paediatric homeopathy in Germany: Results of the German health

interview and examination survey for children and adolescents (KiGGS). Pharmacoepidemiology

and Drug Safety, 18 (5), 370-379.

X

16Fayeton, S., & van Wassenhoven, M. (2001). Clinical verification of symptom pictures of

homeopathic medicines. The British Homoeopathic Journal, 90 (1), 29-32. X X

17

Bracho, G., Varela, E., Fernández, R., Ordaz, B., Marzoa, N., Menéndez, J., . . . Rufín, R. (2010). Large-

scale application of highly-diluted bacteria for Leptospirosis epidemic control. Homeopathy, 99 (3),

156-166.

X



19

Jacobs, J., Williams, A. L., Girard, C., Njike, V. Y., & Katz, D. (2005). Homeopathy for attention-

deficit/hyperactivity disorder: A pilot randomized-controlled trial. Journal of Alternative &


X

20Boyd, W. E., & Brit, M. (2011). Biochemical and biological evidence of the activity of high potencies.

Homeopathy, 100 (1-2), 36-61. X X X

21

Frenkel, M., Mishra, B., Sen, S., Yang, P., Pawlus, A., Vence, L., . . . Banerji, P. (2010). Cytotoxic

effects of ultra-diluted remedies on breast cancer cells. International Journal of Oncology, 36 (2),

395.

X

22Boyd, W., & Brit, M. (2011). Biochemical and biological evidence of the activity of high potencies.

Homeopathy, 100 (1-2), 36-61. X X

23Bellavite, P., Conforti, A., Piasere, V., & Ortolani, R. (2005). Immunology and homeopathy. 1.

Historical background. Evidence Based Complementary and Alternative Medicine, 2 (4), 441-452. X

24 Guillemin, J. (2001). Miasma, malaria, and method. Molecular Interventions, 1 (5), 246-249. X

25Mathur, M. (2009). The concept of miasm - evolution and present day perspective. Homeopathy,

98 (3), 177. X



Systematic

review of level

II studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series

with either

post test or

pre test post

test outcomes

in vivo

animal

studies

in vitro


26Teixeira, M. Z. (2003). Homeopathic use of modern medicines: Utilisation of the curative rebound

effect. Medical Hypotheses, 60 (2), 276-283. X

27Teixeira, M. Z. (2006). Evidence of the principle of similitude in modern fatal iatrogenic events.

Homeopathy, 95 (4), 229-236. X

28Jonas, W. B., Kaptchuk, T. J., & linde, K. (2003). A critical overview of homeopathy. Annals of

Internal Medicine, 138 (5), 393. X

29Bellavite, P., Andrioli, G., Lussignoli, S., Signorini, A., Ortolani, R., & Conforti, A. (1997). A scientific

reappraisal of the 'principle of similarity'. Medical Hypotheses, 49 (3), 203-212. X

30

Van Wassenhoven, M. (2005). Priorities and methods for developing the evidence profile of

homeopathy: Recommendations of the ECH General Assembly and XVIII Symposium of GIRI.

Homeopathy, 94 (2), 107-124.

X

31

Van Wassenhoven, M. (2005). Priorities and methods for developing the evidence profile of

homeopathy: Recommendations of the ECH General Assembly and XVIII Symposium of GIRI.

Homeopathy, 94 (2), 107-124.

X

32 Ernst, E. (2011). Homeopathy in severe sepsis. Homeopathy, 100 (3), 195-195. X

33Weir, J. (2011). Homoeopathic philosophy: Its importance in the treatment of chronic diseases.

Homeopathy, 100 (1-2), 11-17. X

34Mroninski, C., Adriano, E., & Mattos, G. (2001). Meningococcinum, its protective effect against

meningococcal disease. Homoeopath Links, 14 (4), 230e234. X

Cost Effectiveness

35

Golden, I. (2002). The potential value of homoeoprophylaxis in the long-term prevention of

infectious diseases, and the maintenance of general health in recipients. PhD, Swinburne University

of Technology, Melbourne. Retrieved from http://hdl.handle.net/1959.3/26008

X

Quality and Safety

36

Vickers, A., & Smith, C. (2009). Withdrawn: Homoeopathic Oscillococcinum for preventing and

treating influenza and influenza-like syndromes. Cochrane Database Of Systematic Reviews

(Online) (3), CD001957.

X

37

Jacobs, J., Jiménez, L. M., Malthouse, S., Chapman, E., Crothers, D., Masuk, M., & Jonas, W. B.

(2000). Homeopathic treatment of acute childhood diarrhea: Results from a clinical trial in Nepal.

Journal of Alternative and Complementary Medicine , 6(2), 131-139.

X



Systematic

review of level

II studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series

with either

post test or

pre test post

test outcomes

in vivo

animal

studies

in vitro


38Mousavi, F., Mojaver, Y. N., Asadzadeh, M., & Mirzazadeh, M. (2009). Homeopathic treatment of

minor aphthous ulcer: A randomized, placebo-controlled clinical trial. Homeopathy, 98 (3), 137. X

39

Piltan, D., Rist, L., Simões-Wüst, P., & Saller, R. (2009). Test of a homeopathic dilution of Aconitum

napellus. A clinical, randomized, double-blind, controlled crossover study in healthy volunteers.

Forschende Komplementärmedizin/Research in Complementary Medicine, 16(3), 168-173.

X

40

Walach, H., Hennig, T., & Haag, G. (2001). The effects of homeopathic belladonna 30CH in healthy

volunteers: A randomized, double-blind experiment. Journal of Psychosomatic Research, 50 (3), 155-

160.

X

41Chand, S. K., Manchanda, R., Batra, S., & Mittal, R. (2011). Homeopathy in the treatment of

tubercular lymphadenitis (TBLN)-An Indian experience. Homeopathy, 100 (3), 157-167. X

42

Frass, M., Linkesch, M., Banyai, S., Resch, G., Dielacher, C., Löbl, T., . . . Schuster, E. (2005).

Adjunctive homeopathic treatment in patients with severe sepsis: A randomized, double-blind,

placebo-controlled trial in an intensive care unit. Homeopathy, 94 (2), 75-80.

X

43

Thompson, E., Shaw, A., Nichol, J., Hollinghurst, S., Henderson, A., Thompson, T., & Sharp, D.

(2011). The feasibility of a pragmatic randomised controlled trial to compare usual care with usual

care plus individualised homeopathy, in children requiring secondary care for asthma.

Homeopathy, 100 (3), 122-130.

X X

44Kistin, S. J., & Newman, A. D. (2007). Induction of labor with homeopathy: A case report. Journal of

Midwifery & Women's Health, 52 (3), 303-307. X

45

Shang, A., Huwiler-Müntener, K., Nartey, L., Jüni, P., Dörig, S., Sterne, J. A. C., . . . Egger, M. (2005).

Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled

trials of homoeopathy and allopathy. The Lancet, 366 (9487), 726-732.

X

46

Du, Y., & Knopf, H. (2009). Paediatric homeopathy in Germany: Results of the German health

interview and examination survey for children and adolescents (KiGGS). Pharmacoepidemiology

and Drug Safety, 18 (5), 370-379.

X



48

Jacobs, J., Williams, A. L., Girard, C., Njike, V. Y., & Katz, D. (2005). Homeopathy for attention-

deficit/hyperactivity disorder: A pilot randomized-controlled trial. Journal of Alternative &


X

49

Majewsky, V., Arlt, S., Shah, D., Scherr, C., Jäger, T., Betti, L., . . . Baumgartner, S. (2009). Use of

homeopathic preparations in experimental studies with healthy plants. Homeopathy, 98 (4), 228-

243.

X



Systematic

review of level

II studies

Experimental

Studies

RCT or

Pseudo RCT

Non-

experimental

Studies

Case control or

cohort

Case series

with either

post test or

pre test post

test outcomes

in vivo

animal

studies

in vitro


50

Spin-Neto, R., Belluci, M. M., Sakakura, C. E., Scaf, G., Pepato, M. T., & Marcantonio Jr, E. (2010).

Homeopathic Symphytum officinale increases removal torque and radiographic bone density

around titanium implants in rats. Homeopathy, 99 (4), 249-254.

X

51Wiegant, F., & Van Wijk, R. (2010). The similia principle: Results obtained in a cellular model

system. Homeopathy, 99 (1), 3-14. X

52



395.

X

53



395.

X

54Boyd, W., & Brit, M. (2011). Biochemical and biological evidence of the activity of high potencies.

Homeopathy, 100 (1-2), 36-61. X X

55Teixeira, M. Z. (2006). Evidence of the principle of similitude in modern fatal iatrogenic events.

Homeopathy, 95 (4), 229-236. X

56Weir, J. (2011). Homoeopathic philosophy: Its importance in the treatment of chronic diseases.

Homeopathy, 100 (1-2), 11-17. X

57Chattopadhyay, S. (2002). Proposition of a new system of medicine based on tolerance principle.

Medical Hypotheses, 59 (2), 191-203. X

58Jonas, W. B., Kaptchuk, T. J., & linde, K. (2003). A critical overview of homeopathy. Annals of

Internal Medicine, 138 (5), 393. X

59Peper, A. (2004). A theory of drug tolerance and dependence II: The mathematical model. Journal

of Theoretical Biology, 229 (4), 491-500. X

60

Jadad, A. R., Moore, R. A., Carroll, D., Jenkinson, C., Reynolds, D. J. M., Gavaghan, D. J., & McQuay,

H. J. (1996). Assessing the quality of reports of randomized clinical trials: Is blinding necessary?

Controlled Clinical Trials, 17 (1), 1-12.

X

61Peper, A. (2004). A theory of drug tolerance and dependence II: The mathematical model. Journal

of Theoretical Biology, 229 (4), 491-500. X

62 Ernst, E. (2011). Homeopathy in severe sepsis. Homeopathy, 100 (3), 195-195. X

63Roberts, H. A. (1942). The principles and art of cure by homeopathy : A modern textbook. London:

Homœopathic publishing company.T X


17

Acknowledgements Submission prepared on behalf of the ANPA by:

Eta Brand

B.Naturopathy, BSc Public Health, Med.Tech

ANPA President

The Australian Naturopathic Practitioners Association acknowledges the contribution to this

submission from:

Dr Ken Wojcikowski – Southern Cross University

Dr Seroya Crouch – Endeavour College