Evidence-based Boulevard

Just like the book of love, the road to evidence-based medicine is long and boring. The following is an excerpt from an article on the use of black cohosh as a botanical treatment for menopause and dysmenorrhea. It illustrates the tedious process of coming to a reliable conclusion on not only whether a drug works, but exactly how much is necessary.

In clinical studies before 1996, the dose was […] equivalent to 48–140 mg of black cohosh extract per day. A recent clinical trial comparing two different dosages of Remifemin® (40 mg vs. 127 mg daily), for six months, in 116 women with menopausal complaints, found similar safety and efficacy profiles for both doses (Liske et al., 2002). Based upon the results of this trial, a recommended dose equivalent to 40 mg of black cohosh (dried root) daily is currently recommended (Liske, 1998).

Treating asthma with coffee

There was an older movie/TV show in which two unexperienced thieves inadvertently kidnapped a young girl. She experienced an asthma attack during the ordeal, and one of the robbers decided to give her a sip of coffee, which calmed her down. I brought this up during my Wilderness First Responder training as we were discussing asthma, and my instructor who is an experienced EMT, was skeptical, suggesting that it would take more coffee than was practical to have an effect. I set out to see whether he was right.

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