Research into alternative medicine: too little and too flimsy

For some time now, the research activity in and around alternative medicine has been seemingly buoyant. In each of the last 4 years, Medline listed around 2 000 articles is the category of ‘complementary alternative medicine’. This will surely look impressive to many!

Why then did I write ‘seemingly’? To comprehend this a little better, we should have some comparisons. Here are numbers of Medline-listed articles published in 2015 for a few other areas:

• Surgery: 176 277
• Psychology: 65 679
• Internal medicine: 36 998
• Obstetrics/gynaecology: 13 818
• Pharmacology: 194 322
• Paediatrics: 30 646

Now you see, I hope, why the 2 049 Medline-listed articles in the category of ‘complementary alternative medicine’ are only seemingly impressive. But what about specific alternative therapies? Here are numbers of Medline-listed articles published in 2015 for some major alternative treatments:

• Homeopathy: 181
• Herbal medicine: 1 572
• Chiropractic: 314
• Acupuncture: 1 784
• Naturopathy: 45
• Dietary supplements: 5 199

These figures are perhaps interesting but not easy to interpret. They might indicate that certain sections of alternative medicine are more open to scientific scrutiny than others. Or do they show that for some areas there are more research funds and expertise than others? I am not sure I know the answer.

If we look a little closer at the research activity in defined alternative therapies, we are bound to get disappointed. I have recently done this for homeopathy and for acupuncture and reached rather gloomy conclusions.

In the case of homeopathy the were:

1. The research activity into homeopathy is currently very subdued.
2. Arguably the main research question of efficacy does not seem to concern researchers of homeopathy all that much.
3. There is an almost irritating abundance of papers that are data-free and thrive on opinion (my category of ‘other papers’).
4. Given all this, I find it hard to imagine that this area of investigation is going to generate much relevant new knowledge or clinical progress.

And in the case of acupuncture, I stated:

• Too little research is focussed on the two big questions: efficacy and safety.
• In relation to the meagre output in RCTs, there are too many systematic reviews.
• As long as we cannot be sure that acupuncture is more than a placebo, all these pre-clinical studies seem a bit out of place.
• The vast majority of the articles were in low or very low impact journals.
• There was only one paper that I would consider outstanding.

And what about the quality of the research into alternative medicine?

Well, this is a sad and depressing tale! If you doubt it, read my previous post or indeed any of the other ~500 which I have written on this particular subject in the past.