Future Directions and the Path Forward
2018
20.1 Disappointment at Current Lack of Progress Despite the impressive accomplishments that have steadily accumulated since
the 1960s that now consist of the publication of thousands of peer-reviewed
papers [that can be retrieved by a PubMed search using the MeSH term
“LLLT” and a new MeSH term “photobiomodulation therapy” (PBM)] and
hundreds of clinical trials, many of which have been high-quality, randomized,
and well-controlled, LLLT has still not reached the stage of acceptance by
mainstream medicine. There remains considerable skepticism (and sometimes
frank disbelief) amongst biomedical scientists, the medical profession, and the
public at large. The reasons for this skepticism and disbelief are many and various, and
they differ depending on the source. Biomedical scientists often refer to a lack
of mechanism and the absence of agreement on dosimetry and parameters.
Physicians often claim there is a lack of large clinical trials and not enough
systematic reviews. Hospital and insurance administrators cannot agree on
coverage and reimbursement. Finally (and regrettably), there has been
marketing hype, over-promising, and frank misinformation from some of the
companies that make devices (lasers, LED arrays, mixed clusters) that are
used in the LLLT industry.
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