Health: Hidden Truths Behind Healing Hands
Ernst, Edzard, The Independent (London, England)
Complementary medicine is a boom industry, but media hype has often exaggerated the benefits and ignored a lack of hard scientific evidence to support its claims.
WHEN, five years ago, I was appointed as Britain's first (and still only) Professor of Complementary Medicine, I noticed the lively media interest in the subject.
Much of what was being reported on the subject seemed to stem from an extreme 'pro' or an extreme 'contra' position. I decided then to stay out of "media battles" and focus on discussions in scientific publications. Now I am about to make an exception to this rule. Why? The reason is simply that, in my view, the debate has gradually become ill-informed, misleading and seriously unbalanced. Three examples can be given to substantiate this view: over the last eight months we have seen a Channel 4 television series Natural Born Healers; a Sunday Times series by Hazel Courtney (Health Journalist of the Year) "What's the Alternative"; a five-part supplement "Healing. A-Z Guide to Complementary Medicine" in the Times. All three major media events rely heavily on reporting anecdotes of miracle cures in support of what I feel compelled to call a seriously biased view. So, what is wrong with anecdotes? My grandmother smoked 20 cigarettes per day all her adult life and never had lung cancer. Does that mean that smoking does not cause lung cancer? No, it does not. Anecdotes are uniquely uninformative, even dangerous when it comes to generalisable matters of health. Historically, in medicine, we have struggled to get away from testimonials or anecdotes. Exactly 50 years ago, the randomised controlled trial* was introduced as the gold standard to find out whether a given therapy is effective or not. With this tool, we are now able to differentiate between specific therapeutic effects and non-specific (e.g. placebo effects, natural history of the disease) effects and can furthermore determine whether one particular treatment is better than another. Testimonials or anecdotes, as produced so often by those who promote complementary medicine, are a significant step backwards in our endeavour to approach the truth. If we accept them in support of complementary medicine and reject them for orthodox medicine we would de facto have introduced double standards into the evaluation of healthcare. And what is wrong with promoting complementary medicine? Nothing at all, except that promotion of this type should be based on reliable evidence and not on anecdote. Promoting medical treatments differs significantly from, for instance, promoting the sale of cars. But, even if you were about to buy a car, you would probably rely on evidence. The two questions you would be likely to ask (both in relation to a car and a given therapy) are, does it work and is it safe? Testimonials (of car dealers, customers or therapists) will not take you far in finding reliable answers. It is simply common sense that, with health matters, one ought to be doubly cautious and extra critical. The recent press coverage of complementary medicine is neither. It dulls our common sense to follow emotion rather than reason, testimonials rather than science. There are, of course, those who claim that complementary medicine is special, so special that it defies testing through science. I suspect this argument is the result of misconceptions as to what science is about. If, in the present context, science means the evaluation of treatments through randomised controlled trials, the notion that science cannot be applied to complementary medicine is false. In the area of complementary medicine, about 1,000 scientific studies have been published world-wide. This, I think, should be sufficient evidence to show that complementary medicine can be tested scientifically. And what are the results of these studies? Invariably they are complex and prohibit generalisations. They show that some complementary treatments are effective for certain conditions; they show that some treatments are not effective. …