MD, PhD, FMedSci, FSB, FRCP, FRCPEd

In my last post and several others before, I have stated that consumers are incessantly being mislead about the value of alternative medicine. This statement requires evidence, and I intend to provide it – not just in one post but in a series of posts following in fast succession.

I start with an investigation we did over a decade ago. Its primary aim was to determine which complementary therapies are believed by their respective representing UK professional organizations to be suited for which medical conditions.

For this purpose, we sent out 223 questionnaires to CAM organizations representing a single CAM therapy (yes, amazingly that many such institutions exist just in the UK!). They were asked to list the 15 conditions which they felt benefited most from their specific CAM therapy, as well as the 15 most important contra-indications, the typical costs of initial and any subsequent treatments and the average length of training required to become a fully qualified practitioner. The conditions and contra-indications quoted by responding CAM organizations were recorded and the top five of each were determined. Treatment costs and hours of training were expressed as ranges.

Only 66 questionnaires were returned. Taking undelivered questionnaires into account, the response rate was 34%. Two or more responses were received from CAM organizations representing twelve therapies: aromatherapy, Bach flower remedies, Bowen technique, chiropractic, homoeopathy, hypnotherapy, magnet therapy, massage, nutrition, reflexology, Reiki and yoga.

The top seven common conditions deemed to benefit from all twelve therapies, in order of frequency, were: stress/anxiety, headaches/migraine, back pain, respiratory problems (including asthma), insomnia, cardiovascular problems and musculoskeletal problems. It is perhaps important at this stage to point out that some of these conditions are serious, even life-threatening. Aromatherapy, Bach flower remedies, hypnotherapy, massage, nutrition, reflexology, Reiki and yoga were all recommended as suitable treatments for stress/anxiety. Aromatherapy, Bowen technique, chiropractic, hypnotherapy, massage, nutrition, reflexology, Reiki and yoga were all recommended for headache/migraine. Bowen technique, chiropractic, magnet therapy, massage, reflexology and yoga were recommended for back pain. None of the therapies cost more than £60 for an initial consultation and treatment. No correlation between length of training and treatment cost was noted.

I think, this article provides ample evidence to show that, at least in the UK, professional organisations of alternative medicine readily issue statements about the effectiveness of specific alternative therapies which are not supported by evidence. Several years later, Simon Singh noted that phenomenon in a Guardian-comment and wrote about the British Chiropractic Association “they happily promote bogus claims”. He was famously sued for libel but won the case. Simon had picked the BCA merely by chance. The frightening thought is that he could have targeted any other of the 66 organisations from our investigation: they all seem to promote bogus claims quite happily.

Several findings from our study stood out for being particularly worrying: according to the respective professional organisation, Bach Flower Remedies were deemed to be effective for cancer and AIDS, for instance. If their peers put out such irresponsible nonsense, we should not be amazed at the claims made by the practitioners. And if the practitioners tell such ‘tall tales’ to their clients, to journalists and to everyone else, how can we be amazed that we seem to be drowning in a sea of misinformation?

15 Responses to Drowning in a sea of misinformation. Part 1: professional organisations of alternative medicine

  • Rachael Frost says:

    Surely this does not prove that statements are ‘readily’ issued, if you got such a poor response rate of 34%? Surely that suggests that the non-responders are actually somewhat cautious about makign claims. It also depends on how you defined benefit – were these therapies meant to be prescribed/administered alongside conventional therapies or separately? You also ask them to list conditions, and when they do, say this is promoting bogus claims? The questions then seems a bit leading – what were you expecting people to answer without giving a lengthy treatise and summary of the available evidence? I’m curious as to whether professional bodies within the NHS could answer similar questions about the top 15 conditions that could benefit from them in full accordance with the evidence either! Out of interest, what were the most important contraindications for each therapy? Was this in line with the evidence?

    • Edzard says:

      I think the non-response rate was due to a reluctance of most organisations to co-operate with a research team that had a name for being critical. my SPECULATION is that the non-responders would have been even worse.
      contra-indications: many were named but the info was full of contradictions; as there is very little reliable evidence about contra-indications, I find it impossible to say to what extend this was based on evidence.

  • Rachael Frost says:

    My own speculation would be that organisations staffed primarily by volunteers probably wouldn’t have to time to sift through the available evidence to provide a coherent and thorough response, though you may be also be right about cooperating with heavy critics!

      • Rachael Frost says:

        My point was that they likely didn’t reply due to volunteers’ lack of time, not that the replies from the respondents were due to lack of time. Lack of response does not make an unethical organisation!

  • Aly says:

    You are presenting misleading facts. It is obvious these therapies are listing conditions (of which they have firsthand evidence in their practices and training) which can be eased, soothed, or possibly lessened. You have misled by insinuating that these therapists claim the entire conditions are cured or abated by these therapies. That is unlikely the intent of the therapists.

    If you suffered from a condition which causes a series of terrible symptoms that are not relieved by conventional treatments, you might also seek a therapy that could at least possibly relieve aspects of those symptoms. Shame on you for imparting your own unsolicited skepticism on things that may provide a bit of light to those in the dark.

    Meanwhile conventional medicine continues to be extremely dangerous,, indeed a leading cause of death althoughtit saves many lives too. People should have every right to decide when to pursue conventional treatments, and/or to utilize adjunct or alternative therapies, or in the absence of effective conventional treatment, pursue alternative therapies.

  • Ex-Acupuncturist says:

    The National Commission for the Certification of Acupuncture and Oriental Medicine (NCCAOM) approves Continuing Education courses for acupuncturists. The state I’m licensed in accepts these for CEU credit. So many of the CEU courses are pure BS. Absolute pseudo-science. And poorly done at that–courses I took for my required CEUs were shoddily put together, full of typos, errors in basic history, and plenty of bogus interpretations of bad studies. I complained to the NCCAOM and suggested that I could put together better quality CEU courses, but they suggested that since I’d let my membership to their group lapse, I wasn’t showing dedication to the profession and thus wasn’t able to get their ‘Certification’ for CEU courses without paying them extra fees. I’ve since moved on to non-acupuncture business ventures with a much wider market of more intelligent people.

  • dazydee says:

    >>They were asked to list the 15 conditions which they felt benefited most from their specific CAM therapy<<

    Well, since every condition benefits from placebo, most answers are technically correct….

  • Ex-Acupuncturist says:

    @Dazydee–Not every condition benefits from placebo. Placebo changes perception of discomfort, and mainly shows up in subjective reports of pain and nausea. Placebo effects do not, as far as I know, speed bone healing, reduce hardening of the arteries, produce insulin, shrink tumors, etc. Conditioning can be used to associate flavors, etc., with some deeper effects, such as the flavor of alcohol changing blood pressure, the flavor of sweet being associated with immunosuppressive drugs and causing an immune reaction later when not associated (that was an important rodent study in the 70s).
    Furthermore, in some studies on acupuncture for nausea the results have been that the patient reported having less nausea, but had the same amount of vomiting as the no-treatment control. This can indicate more of a reporting bias (not wanting to let down one’s practitioner) than a true placebo effect.

  • dazydee says:

    Thank you for your answer. The most important findings concerning placebos in a few lines. May I borrow it on occasion?

    I just wanted to make the point, that the persons these questionnaires were sent to probably have a very different understanding what a benefit for a condition is, or even what a condition is. In the realms of iris and tounge diagnosed blocked chakras and chi imbalance there are no objective outcomes. Feeling better is everthing.

    Sorry for teasing.

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