The aim of this Health Technology Assessment Report was to analyse the current situation, efficacy, effectiveness, safety, utilization, and costs of Anthroposophic Medicine (AM) with special emphasis on everyday practice. Design: Systematic review. Material and Methods: Search of 20 databases, reference lists and expert consultations. Criteriabased analysis was performed to assess methodological quality and external validity of the studies. Results: AM is a complementary medical system that extends conventional medicine and provides specific pharmacological and non-pharmacological treatments. It covers all areas of medicine. 178 clinical trials on efficacy and effectiveness were identified: 17 RCTs, 21 prospective and 43 retrospective NRCTs, 50 prospective and 47 retrospective cohort studies/case-series without control groups. They investigated a wide range of AM-treatments in a variety of diseases, 90 × mistletoe in cancer. 170 trials had a positive result for AM. Methodological quality differed substantially; some studies showed major limitations, others were reasonably well conducted. Trials of better quality still showed a positive result. External validity was usually high. Side effects or other risks are rare. AMpatients are well educated, often female, aged 30-50 years, or children. The few economic investigations found less or equal costs in AM because of reduced hospital admissions and less prescriptions of medications. Conclusion: Trials of varying design and quality in a variety of diseases predominantly describe good clinical outcome for AM, little side effects, high satisfaction of patients and presumably slightly less costs. More research and more methodological expertise and infrastructure are desirable.

No abstract

Routine immunization against mumps was included in the MMR-elimination-programme of Switzerland despite the lack of any public health necessity. Seven years later, the theoretical presumptions of the mumps immunization campaign are challenged by practical experiences: An unnecessary vaccination proves to be of insufficient efficacy, yet associated with an unexpected high complication rate and bears thus the risk of discrediting also other immunizations in the general public. What could be considered a particular immunization failure reveals important inconsistencies of the entire MMR-mass-immunization-campaign. The project remains epidemiologically highly vulnerable and thus hazardous. Because of its constraining effects on the general population, compatibility with basic civil rights can be questioned. The reasons why some 20% of the Swiss population refuse mumps vaccination are little investigated so far. Nevertheless, research can provide important clues for further investigations in this field. As the maturation of the immune system follows learning principles, the question arises whether childhood diseases are not essential for the normal development of immunocompetence. In cancer therapy new attention is drawn to hyperthermia and thus to the healing potential of fever. And finally, there are concerns about the longterm effects of manipulations of the natural balance between man and microorganisms.