Box 4
Safety of complementary therapies
| Acupuncture | Homoeopathy | Manipulation | |
|---|---|---|---|
| *Yes in case of infection. | |||
| †Fracture rates might be minimised by excluding high risk patients (for example, menopausal women). | |||
| Evidence presented in this table is based on Ernst et al,32 Assendelft et al,35 and Ernst et al.37 | |||
| Examples of serious adverse effects | Trauma, infections | Allergies | Fractures, stroke |
| Fatalities reported? | Yes | No | Yes |
| Frequency of adverse effects known? | No | No | No |
| Complication avoidable? | No* | No | No† |
| Indirect safety issues | • Potentially applicable to all complementary therapies: | ||
| • Missed diagnoses | |||
| • Misdiagnoses | |||
| • Disregarding contraindications | |||
| • Discontinuation, prevention/delay of effective therapy | |||
| • Potentially hazardous diagnostic procedures | |||
