Ginkgo biloba for mild to moderate dementia in a community setting: a pragmatic, randomised, parallel-group, double-blind, placebo-controlled trial.

Objectives: Doubt over the cost-effectiveness of the cholinesterase inhibitors in dementia has renewed interest in alternative treatments such as Ginkgo biloba. We aimed to determine the effectiveness and the safety profile of Ginkgo biloba for treating early stage dementia in a community setting.

Methods: We conducted a community-based, pragmatic, randomised, double-blind, parallel-group trial where participants were given a standardised extract of Ginkgo biloba (120 mg daily) or a placebo control for 6 months.

The Hawthorne Effect: a randomised, controlled trial.

Background: The 'Hawthorne Effect' may be an important factor affecting the generalisability of clinical research to routine practice, but has been little studied. Hawthorne Effects have been reported in previous clinical trials in dementia but to our knowledge, no attempt has been made to quantify them. Our aim was to compare minimal follow-up to intensive follow-up in participants in a placebo controlled trial of Ginkgo biloba for treating mild-moderate dementia.

Evaluation of specific and non-specific effects in homeopathy: feasibility study for a randomised trial.

Objective: To determine the feasibility, in terms of acceptability to patients, physicians and other staff; data return and statistical power of a study to elucidate the relative contributions of specific and non-specific effects in homeopathic treatment of dermatitis.

Design: Randomised, controlled 4-arm trial, 2 arms double-blind.

Setting: Outpatient clinic, Royal London Homoeopathic Hospital.

Labelling chronic illness in primary care: a good or a bad thing?

Traditionally the management of any chronic condition starts with its diagnosis. The labelling of disease can be beneficial in terms of defining appropriate treatment such as in coronary artery disease. However, sometimes it may be detrimental such as when x-rays are used to diagnose lumbar spondylosis leading to patients inappropriately limiting their activity.

Effectiveness gaps: a new concept for evaluating health service and research needs applied to complementary and alternative medicine.

Background: An effectiveness gap (EG) is an area of clinical practice in which available treatments are not fully effective. EGs have not been previously researched. Complementary and alternative medicine (CAM) interventions, by definition, are not generally available through normal health care channels.

Cost effectiveness analysis of a randomised trial of acupuncture for chronic headache in primary care.

Objective: To evaluate the cost effectiveness of acupuncture in the management of chronic headache.

Design: Cost effectiveness analysis of a randomised controlled trial.

Setting: General practices in England and Wales.

Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial.

Objective: To determine the effects of a policy of "use acupuncture" on headache, health status, days off sick, and use of resources in patients with chronic headache compared with a policy of "avoid acupuncture."

Design: Randomised, controlled trial.

Setting: General practices in England and Wales.

Use of a single global assessment to reduce missing data in a clinical trial with follow-up at one year.

We conducted a randomized controlled trial (ISRCTN96537534) to assess the effects of acupuncture on migraine and chronic tension headache. Patients (n=401) completed a diary of headache severity four times a day for 4 weeks at baseline, immediately following a 3-month treatment period and 1 year after randomization. During the trial, it appeared that dropout might be higher than expected.