Alternative Medicine the Verdict; -

Daily Mail (London), April 15, 2008 | Go to article overview
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Alternative Medicine the Verdict; -


Byline: SIMON SINGH, EDZARD ERNST

JUST how effective is complementary medicine? In a new book, EdzardErnst, a pioneering 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 doesnt. Their compelling account sets out whatthey found, and it makes for 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 centuries about all kinds 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, perceivingevidence-based medicine as a strategy for allowing the medical establishment todefend its own members and treatment, while excluding outsiders who offeralternative 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 a fair, thorough and scientificassessment of the evidence.

So what did we find? Well, while some therapies do provide some health benefits(osteopathy, for example), most have nothing to offer.

Many popular therapies are effective only because they are good at eliciting aplacebo response; making the patients 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 essentially a bogustreatment. And its 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.

AND WHAT about the cost to the Department of Health of whatever complementaryor alternative treatments are permitted under the public health system?

Many people would argue that any money spent on unproven or dis-proventherapies could be put to far better use, for example, to pay for more nursesor fund additional operations or assist patients lying on trolleys in theaccident and emergency departments of hospitals.

Too many alternative therapists remain uninterested in determining the safetyand efficacy of their interventions.

These practitioners also fail to see the importance of rigorous clinical trialsin establishing proper evidence for or against their treatmentswhere evidence already exists that treatments are ineffective or unsafe,alternative therapists carry on regardless.

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