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P Heusser

Publications and source records attributed to P Heusser.

16 recordsLinked to original sources
PubMed2002

Socio-demographic and medical characteristics of advanced cancer patients using conventional or complementary medicine.

BACKGROUND: To provide prospective comparative data describing the profiles of two patient populations attending conventional or complementary medicine institutions. PATIENTS AND METHODS: A registration study was set up in an oncology ward at the Institute for Medical Oncology (IMO) of the University Hospital in Bern, and at the Lukas Clinic (LC) for Anthroposophical Cancer Treatment in Arlesheim, Switzerland. The same eligibility criteria were applied to enrol into the study all newly referred or newly diagnosed patients with advanced cancer over a 2-year period. Their socio- demographic and clinical characteristics at presentation have been compared between the two institutions. RESULTS: Patients at LC are primarily females, of higher educational level, and living in an urban environment. Patients at LC are also more frequently of poorer performance status but present with less comorbidity and a longer interval between diagnosis of metastatic disease and accrual into the study. CONCLUSION: This study suggests that the respective merits of these two schools of medicine can be assessed successfully only through a concrete research partnership based on rigorously controlled clinical trials.

Adult↗
PubMed2001

[Criteria for assessing benefit with complementary medical methods].

UNLABELLED: Criteria for Assessing Benefit with Complementary Medical Methods BACKGROUND: The paper was produced by the author at the request of the Swiss Federal Social Insurance Department in a broad-based consensus process involving the principal parties in the health system, discussed with international experts at a public workshop, and finally approved in the form it is presented here by the Services Commission of the Federal Home Office on March 12, 1998. It provides a basis for assessing the efficacy, suitability and financial viability of complementary medical methods in the context of Swiss health insurance legislation. CONTENTS: Evidence-based complementary medicine cannot rest entirely on experimental trials but needs all available methods of obtaining evidence to arrive at a fair assessment, from the empirical judgement of individual medical practitioners to randomized double blind trials. In addition to experimental trials, special emphasis lies on test methods involving no experimental change in the medical intervention and the conditions pertaining to it. In so far as the experimental design on which randomized double blind trials are based takes no account of factors that are integral to holistic and individualized complementary medical treatment (e.g., the individual aspect of the doctor-patient relationship, and motivation), other evaluation concepts are needed that will do justice to these methods, such as evaluation of the overall clinical situation.The same applies when it is a matter not only of the efficacy of a method within the closely defined framework of experimental trials but also of its effectiveness in a wider context in practice and the context-related situation in the target population for the social security system (real world effectiveness). It is important for evaluation to be not primarily design-orientated but problem-orientated, with the design developed accordingly.

Complementary Therapies↗
PubMed2000

Experiences in the realisation of a research project on anthroposophical medicine in patients with advanced cancer.

QUESTIONS UNDER STUDY: To date most of the published studies on the effectiveness of complementary therapies in cancer patients have yielded controversial results because of questionable methodology. Research strategies and methodologies acceptable to both conventional and unconventional medicine are difficult to find due to different belief systems. In this publication we describe the development and implementation of a project conducted as part of National Research Programme 34 (NFP 34). Detailed analysis of our experiences might provide some information on how to deal with practical difficulties in the planning and conduct of further research projects in this field. The project involved the anthroposophical Lukas Clinic in Arlesheim and the Institute of Medical Oncology of the University Hospital, Berne. This interdisciplinary research project was devised to study the relative merits of these two schools of medicine in the care of advanced cancer patients. The project was made up of three components: (1) a registration study aimed at comparing the case mix at the two institutions; (2) a three armed randomised study on the effectiveness of supportive therapy, comparing anthroposophy to psychosocial group therapy, and (3) a longitudinal study to monitor the evaluation of quality of life of patients at the anthroposophical clinic. METHODS: After a brief review of the study protocol, which presents the theoretical framework of the project, problems of its implementation are described. Aspects of accrual, acceptance of randomisation and data availability are presented using simple descriptive statistics and logistic regression. RESULTS: The registration study was duly completed with a total of 567 patients. For several reasons (not meeting inclusion requirements, high refusal rate) the accrual into the randomised study was slower than expected and required modification of the original design specifications with regard to inclusion criteria and data collection schedule. Additionally, a high dropout rate contributed to premature closure of this part of the project. The longitudinal study also suffered from low data availability at follow up. CONCLUSIONS: The study protocol constituted a major effort at compromise without loss of scientific rigour, and this effort demonstrates that it is possible to allow for different views on patients, on clinical interventions and on research strategies when establishing collaboration between different schools of medicine. Despite a theoretically sound framework, the randomised part of the project proved difficult in its practical execution. Some unexpected logistical constraints and some unmet expectations influenced the feasibility of this part of the project. Therefore, careful planning of research projects in this field of medicine should always include an extended analysis of various practical aspects of study implementation.

Anthroposophy↗
PubMed2000

Immunomodulatory and clinical effects of Viscum album (Iscador M and Iscador P) in children with recurrent respiratory infections as a result of the Chernobyl nuclear accident.

Ninety-two children 5 to 14 years of age living in areas exposed to the radioactive fallout from Chernobyl with recurrent respiratory infections (RRIs) were treated after randomization with either Viscum album praeparatum mali or pini (Iscador M or P). The dosage was two subcutaneous injections a week for 5 weeks with individual doses of 0.001 mg to 1.0 mg. Both Viscum album preparations were effective in significantly reducing clinical symptoms. One year after a single treatment course, the frequency of RRI relapses decreased by 78% and 73%, respectively. Immunomodulatory effects were assessed by investigation of lymphocyte subsets, natural killer (NK) cell activity, phagocytic and oxidative activity of polymorphonuclear leukocytes, and antiviral activity of serum before and 1 week after treatment. Viscum album therapy resulted in normalization of initial immune indices either below or above the normal ranges. High levels of antiviral activity before treatment were significantly decreased by Viscum album mali. Viscum album treatment should be studied further in children with RRI.

Adolescent↗
PubMed2000

Commentary on Sommer et al. 'A randomized experiment of the effects of including alternative medicine in the mandatory benefit package of health insurance.

The study by Sommer et al. recently reported in Complementary Therapies in Medicine has been heavily criticised in Switzerland since its original publication. Its major problems are an inadequate reflection of real practice, an inadequate study design relative to the central research objective, questionable value of the applied instrument and procedure for health assessment, methodological and statistical problems, and failure to consider literature relevant to the topic. For these reasons, this experimental study does not allow an answer to its central questions as to costs and effectiveness of complementary medicine made available within Switzerland's mandatory basic health insurance provisions. We propose more practice-related, non-experimental prospective study designs to realistically answer these questions.

Complementary Therapies↗
PubMed1999

[Problems of study designs with randomization, blinding and placebos].

As randomised double-blind trials are not rarely demanded as a prerequisite for the scientific acceptance of complementary medicine, the author has analysed the soundness of this demand on the basis of the international literature. As a result there appeared a number of methodological, practical and ethical problems which question the theoretically deduced primal value of this study design relative to the needs of medical practice and of health insurance issues. The experimental instruments of randomisation, blinding and placebo deliberately exclude essential therapeutic factors which are integral elements of complementary medical concepts; therefore, it is suggested to supplement quantitatively and collectively oriented experimental research by non-experimental procedures, which adequately reflect the context- and practice-related individual reality.

Bioethics↗
PubMed1999

[Quality of life of patients with metastatic breast or intestinal cancer, treated with anthroposophic medicine or with mainstream medicine, the latter with or without psycho-oncologic or supplementary anthroposophic therapy].

This project dealt with two subjects. On the one hand, the measurement of the quality of life of cancer patients which needed to be further refined in order to assess the usefulness and efficacy of a treatment by complementary medicine. On the other hand, it was important to know whether severely ill cancer patients treated in an anthroposophical clinic would differ from equally ill patients in a university hospital in terms of attitude towards their illness and in terms of clinical diagnosis. Finally, an attempt was made to demonstrate an improvement of quality of life in conventionally treated patients of the university hospital, who were offered an additional treatment either with a supportive-expressive group therapy or with an anthroposophical therapy. More than 500 patients participated in the study. There were marked sociodemographic and medical differences between the patients of the anthroposophical clinic and those of the university hospital. In addition, it seems that spiritually oriented and active, problem-oriented coping contribute a lot to the quality of life. It was not possible to truly compare the value of the two additional therapies offered to the patients at the university hospital because patient accrual was much slower than anticipated and many patients left the study too early for health reasons or death.

Ambulatory Care Facilities↗
PubMed1998

The cognitive-spiritual dimension--an important addition to the assessment of quality of life: validation of a questionnaire (SELT-M) in patients with advanced cancer.

UNLABELLED: Questions of meaning and challenge by illness, i.e., the spiritual dimension of quality of life (QL) traditionally played an important role in anthroposophically oriented medicine and have gained importance in palliative medicine and supportive care. In the context of a research project on QL in patients with advanced cancer, we therefore investigated the psychometric properties of a questionnaire covering spiritual QL issues, with the aim of providing a module for the assessment of cognitive-spiritual QL. PATIENTS AND METHODS: We investigated 89 patients with advanced breast and gastro-intestinal cancer. Construct validity of a modified version of the SELT (Skalen zur Erfassung von Lebensqualität bei Tumorkranken), the SELT-M was tested by multitrait scaling analysis. Discriminant and convergent validity were also tested. The EORTC QLQ-C30 was used as a standard for validation. Results showed the SELT-M as feasible in administration. Four of the five SELT-M subscales were internally consistent (Cronbach's Alpha = > 0.7). The subscale on spiritual QL showed higher within than outside subscale correlations for six of its eight items. Association of the SELT-M with the EORTC QLQ-C30 was good for the items and subscales covering the same aspects of QL in both questionnaires: emotional (Spearman r = 0.61), physical functioning (r = -0.54) and fatigue (r = -0.75). In accordance with expectations, there was no association between spiritual QL with any EORTC QLQ-C30 subscales. Self-assessed spiritual QL in the SELT-M corresponded well with interviewer assessments (test for trend accross ordered groups, P = 0.0023). CONCLUSIONS: Overall there is confirming evidence for the hypothesised structure of the SELT-M, especially for the newly developed module on spiritual QL. This module may be used as a module together with other cancer specific QL questionnaires.

Breast Neoplasms↗
PubMed1994

[Does non-conventional complementary therapies improve the quality of life of cancer patients? A critical literature review].

Despite substantial progress in biomedicine, a majority of advanced cancer diseases currently cannot be cured. In addition to conventional medical symptom management (palliation) and improvement of quality of life, methods of complementary medicine and supportive psychotherapy are increasingly applied. Whereas the efficacy of biomedical and psychotherapeutic interventions has been documented, controlled investigations of complementary methods are rare and their efficacy is poorly documented or is viewed controversially. Complementary methods are defined as methods applied by conventionally trained physicians and are based on tradition, or the perspective of human arts, which are not investigated or taught at universities. As an example of the latter, anthroposophic medicine is presented. Finally, we present a project developed within the scope of NFP 34, where the efficacy of a routine biomedical treatment is compared with an additional anthroposophic and psychotherapeutic intervention respectively.

Anthroposophy↗
PubMed1993

[Health and illness from an anthroposophical viewpoint. Lecture at the Summer Academy, '92 Lucerne].

Health and disease are only understood when man is not solely perceived as a physical, but also as a living, a psychic and a spiritual being. The scientific perception of physis has to be complemented by a likely scientific notion of the immaterial in man (life, soul, spirit). To this goal a human science is required like "Anthroposophy" to which I.P.V. Troxler from Lucerne (1780-1860) aspired and which was finally founded by R. Steiner (1861-1925). A really human medicine will only be regained by such an extension of modern medicine by humanities.

Anthroposophy↗
PubMed1993

[Not Available].

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History, Ancient↗