Byline: SIMON SINGH, EDZARD ERNST
JUST how effective is complementary medicine? In a new book, EdzardErnst, the UK's first professor of complementary medicine, and Simon Singh, aleading scientist and documentary maker, set out to answer that question. Theyhave produced a definitiveif controversialguide to what works, and what doesn't. Here, in the first of a two-part series,they explain what they found.
It makes indispensable, if sometimes alarming, reading..
WHICH therapies work and which ones are useless? Which therapies are safe andwhich ones are dangerous? These are questions that doctors have askedthemselves for millennia in relation to all forms of medicine.
And yet it is only comparatively recently that they have developed an approachthat allows them to separate the effective from the ineffective, and the safefrom the dangerous.
This approach, known as evidence-based medicine, has revolutionised medicalpractice, transforming it from an industry of charlatans and incompetents intoa system of healthcare that can deliver such miracles as transplanting kidneys,removing cataracts, combating childhood diseases, eradicating smallpox andsaving millions of lives each year.
Evidence-based medicine is about using the current best evidencegathered through clinical trials and other scientific investigationsto make medical decisions. Alternative medicine claims to be able to treat thesame illnesses and diseases that conventional medicine tries to tackle.
We set out to establish the truth of these claims by using the principles ofevidence-based medicine..
Some people will be suspicious of this, perceiving evidence-based medicine as astrategy for allowing the medical establishment to defend its own members andtreatment, while excluding outsiders who offer alternative treatments.
In fact, the opposite is often trueevidence-based medicine actually allows outsiders to be heard; it endorses anytreatment that turns out to be effective, however strange it may seem.
In the 18th century, for instance, lemon juice as a treatment for scurvy wasregarded as implausible but the establishment had to accept it because it wasbacked up by evidence from trials.
We had no axe to grindindeed Professor Ernst even practised as a homeopath for many years (as well asreceiving treatment as a patient) - and we came to our conclusions based on afair, thorough and scientific assessment of the evidence.
So what did we find?
While some therapies do provide some health benefits (e.g. osteopathy), mosthave nothing to offer.
Many popular therapies are 'effective' only because they are good at elicitinga placebo response; making the patient feel better simply because they believethe treatment will help.
You might feel that as placebos help patients, this alone justifies the use ofthe therapy. But any treatment that relies on the placebo effect is essentiallya bogus treatment. And it's far from cheap.
Alexander Technique, for example, can require between 30 and 100 sessions witha therapist.
If alternative practitioners are making unproven, disproven or vastlyexaggerated claims, and if their treatments carry risks, then we are beingswindled at the expense of our own good health. A ND WHAT about the cost to theNHS? The [pounds sterling]500million it spends annually on unproven or disproven therapiescould instead, for example, pay for 20,000 more nurses.
Too many alternative therapists remain uninterested in determining the safetyand efficacy of their interventions. These practitioners also fail to see theimportance of rigorous clinical trials in establishing proper evidence for oragainst their treatmentswhere evidence already exists that treatments are ineffective or unsafe,alternative therapists carry on regardless.
Despite this disturbing situation, the market for alternative treatments isbooming, and the public is being misled over and over again, often by misguidedtherapists; sometimes by exploitative charlatans. …