MD, PhD, FMedSci, FRSB, FRCP, FRCPEd
I have mentioned it before, I know, but it seems important, so please bear with me as I revisit the subject: there is no other area of health care that is more plagued by surveys than alternative medicine. They are usually conducted on a small convenience sample of consumers and try to tell us that many of them use and like alternative medicine (or a specific alternative treatment). And why is this important? Because this information is subsequently employed to convince us, politicians, journalists, heirs to the throne etc. that thousands of consumers cannot be wrong and that alternative medicine must therefore be a good thing.
Sceptics know, of course, that this argumentum ad populum is a classical fallacy. Recently, we published an article which provides fairly hard evidence to substantiate this fact.

The main aim of our systematic review was to estimate the prevalence of use of alternative medicine (AM) in the UK. Five databases were searched for peer-reviewed surveys published between 1 January 2000 and 7 October 2011. In addition, relevant book chapters and files from our own departmental records were searched by hand. Eighty-nine surveys were included, with a total of 97,222 participants. Surely, fact that this large amount of UK surveys had emerged in only about one decade, speaks for itself.

Most studies turned out to be of poor methodological quality. Across all surveys, the average one-year prevalence of AM-use was 41.1%, and the average lifetime prevalence was 51.8%. However, many of these investigations were flimsy. According to methodologically sound surveys, the equivalent rates were 26.3% and 44%, respectively. In surveys with response rates >70%, the average one-year prevalence was nearly threefold lower than in surveys with response rates below 50%. Herbal medicine was the most popular CAM, followed by homeopathy, aromatherapy, massage and reflexology.

To the best of my knowledge, this is the first time that four crucial points about such surveys have been clearly documented:

1) The amount of surveys in AM is staggering.

2) They contribute very little worthwhile knowledge and mostly seem to be exercises in AM-promotion.

3) Their methodological quality is usually low.

4) The poor quality surveys systematically over-estimate the prevalence of AM-use.

I think it is time that AM investigators focus on real research answering important questions which advance out knowledge, that AM-journal editors stop publishing meaningless nonsense, and that decision-makers understand the difference between promotion dressed up as science and real research.

 

 

5 Responses to Alternative medicine promotion dressed up as research

  • Only one problem: if SCAM journals stop publishing methodologically poor sales pitches masquerading as research, they will have nothing to print! I suppose on Hahnemanian principles that will make them more potent…

    • i think this is a very good point. perhaps also medline should be a bit more critical as to what journals it lists?

      • Quite so. I think a campaign by actual scientists to get some of the more obvious junk delisted (or at least flagged as chronically unreliable and for entertainment purposes only) might help.

        Even NCCAM acknowledges that homeopathy is bunk, but homeopathy is still PubMed indexed – and some of its publications really are priceless.

  • In my very small way I try hard to point out and debunk the insidious creep of nonsense, non-science, pseudoscience, and anti-science being used to distort the following for the sole purpose of financial gain: medicine, biology, chemistry, physics, quantum physics, psychology, psychiatry, cognitive neuroscience, philosophy, theology, and a few other areas of importance to human wellbeing.

    Science, therefore each of its branches, is self-correcting.

    Quackery is a hotchpotch of incompatible ideas and dogmas: its many branches are in conflict with each other over everything other than milking gullible consumers for as much money as possible. As an institution, quackery will survive even though its conflicting branches will endlessly wax and wane in their popularity — as happens in all areas of the fashion industry. It’s a business, not a remedy. I look forward to the day when legislation demands that its advertisements have to include “For the purposes of entertainment only.” as is currently required for the quackery of “psychic mediums” and astrologers.

    Stalling on solid research is the default modus operandi of quackery — and one of its profound hallmarks.

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