The volume of medical research, as listed on Medline, is huge and increases steadily each year. This phenomenon can easily be observed with simple Medline searches. If we use search terms related to conventional medicine, we find near linear increases in the number of articles (here I do not make a distinction between types of articles) published in each area over time, invariably with a peak in 2013, the last year for which Medline listing is currently complete. Three examples will suffice:
PHARMACOTHERAPY 117 414 articles in 2013
PHARMACOLOGY 210 228 articles in 2013
ADVERSE EFFECTS 86 067 articles in 2013
Some of the above subjects are obviously heavily industry-dependent and thus perhaps not typical of the volume of research in health care generally. Let’s therefore look up three fields where there is no such powerful industry to support research:
PSYCHOTHERAPY 7 208 articles in 2013
PHYSIOTHERAPY 7 713 articles in 2013
SURGERY 154 417 articles in 2013
Now, if we conduct similar searches for topics related to alternative medicine, the picture changes in at least three remarkable ways: 1) there is no linear increase of the volume per year; instead the curves look flat and shapeless (the only exception is ‘herbal medicine’ where the increase even looks exponential). 2) The absolute volume does not necessarily peak in 2013 (exceptions are ‘acupuncture’ and ‘herbal medicine’). 3) The number of articles in the year with the most articles (as listed below) is small or even tiny:
ACUPUNCTURE 1 491 articles in 2013
CHIROPRACTIC 283 articles in 2011
HERBAL MEDICINE 2 503 articles in 2013
HOMEOPATHY 233 articles in 2005
NATUROPATHY 69 articles in 2010
You may think: so what? But I find these figures intriguing. They demonstrate that the research output in alternative medicine is minimal compared to that in conventional medicine. Moreover, they imply that this output is not only not increasing steadily, as it is in conventional medicine, but in the case of chiropractic, homeopathy and naturopathy, it has recently been decreasing.
To put this into context, we need to know that:
- there is a plethora of journals dedicated to alternative medicine which are keen to publish all sorts of articles,
- the peer-review process of most of these journals seems farcically poor,
- as a result, the quality of the research into alternative medicine is often dismal, as regularly disclosed on this blog,
- enthusiasts of alternative medicine often see rigorous research into their subject as a dangerous threat: it might disprove their prior beliefs.
In their defence, proponents of alternative medicine would probably claim that the low volume of research is due to a severe and unfair lack of funding. However, I fail to see how this can be the sole or even the main explanation: areas of conventional medicine that do not have industry support seem to manage a much higher output than alternative medicine (and I should stress that I have chosen 5 sections within alternative medicine that are associated with the highest number of articles per year). Research in these areas is usually sponsored by charitable and government sources, and it needs to be stressed that these are open to any researcher who submits good science.
What follows, I think, is simple: in general, alternative medicine advocates have little interest in research and even less expertise to conduct it.