MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

For quite some time now, I have had the impression that the top journals of general medicine show less and less interest in so-called alternative medicine. So, I decided to do some Medline searches to check. Specifically, I searched for 4 different SCAMs:

  • homeopathy
  • acupuncture
  • chiropractic
  • herbal medicine

I  wanted to see how often 7 leading medical journals from the US, UK, Australia, Germany, and Austria carried articles indexed under these headings:

  • JAMA – US
  • NEJM – US
  • BMJ – UK
  • Lancet – UK
  • Aust J Med – Australia
  • Dtsch Med Wochenschrift – Germany
  • Wien Med Wochenschrift – Austria

This is what I found (the 1st number is the total number of articles ever listed; the 2nd number is the maximum number in any year; the 3rd number in brackets is the year when that maximum occurred)

JAMA

Homeopathy: 17, 3 (1998)

Acupuncture: 176, 21 (2017)

Chiropractic: 49, 4 (1998)

Herbal medicine: 43, 5 (2001)

NEJM

Homeopathy: 6, 3 (1986)

Acupuncture: 49, 8 (1974)

Chiropractic: 43, 13 (1980)

Herbal medicine: 29, 12 (1999)

BMJ

Homeopathy: 122, (10, 1995)

Acupuncture: 405, 31 (2021)

Chiropractic: 99, 11 (2021)

Herbal medicine: 158, 13 (2018)

Lancet

Homeopathy: 75, 11 (2005)

Acupuncture: 93, 12 (1973)

Chiropractic: 20, 5 (1993)

Herbal medicine: 46, 6 (1993)

Aust J Med

Homeopathy: 9, 2 (2010)

Acupuncture: 78, 13 (1974)

Chiropractic: 34, 4 (1985)

Herbal medicine: 20, 2 (2017)

Deutsche Medizinische Wochenschrift

Homeopathy: 27, 4 (1999)

Acupuncture: 34, 6 (1978)

Chiropractic: 14, 3 (1972)

Herbal medicine: 6, 1 (2020)

Wiener Medizinische Wochenschrift

Homeopathy: 11, 4 (2005)

Acupuncture: 32, 8 (1998)

Chiropractic: 8, 2 (1956)

Herbal medicine: 16, 3 (2002)

These figures need, of course, to be taken with a rather large pinch of salt. There are many pitfalls in interpreting them, e.g. misclassifications by Medline. Yet they are, I think, revealing in that they suggest several interesting trends.

  1. All in all, my suspicion that the top journals of various countries are less and less keen on SCAM seems to be confirmed. The years where the maximum of papers on specific SCAMs was published are often long in the past.
  2. The UK journals seem to be by far more open to SCAM that the publications from other countries. This is mostly due to the BMJ – in fact, it turns out to be the online journal ‘BMJ-open’. And this again is to a great part caused by the BMJ-open carrying a sizable amount of acupuncture papers in recent months.
  3. The two US journals seem particularly cautious about SCAM papers. When looking at the type of articles in the US journals (and especially the NEJM), one realizes that most of them are ‘letters to the editor’ which seems to confirm the dislike of these journals for publishing original research into SCAM. Another interpretation of this phenomenon, of course, would be that only very few SCAM studies are of a high enough quality to make it into these two top journals.
  4. I was amazed to see how little SCAM was published in the two German-language journals. Vis a vis the high popularity of SCAM in these countries, I find this not easy to understand. Perhaps, one also needs to consider that these two journals publish considerably less original research than the other publications
  5. If we look at the differences between the 4 types of SCAM included in my assessment, we find that acupuncture is by far the most frequently published modality. The other 3 are on roughly the same level, with chiropractic being the least frequent – which I thought was surprising.
  6. Overall, the findings do not generate the impression that – despite the many billions spent on SCAM research during the last decades – SCAM has made important inroads into science or medicine.

I have often commented on the dismal state of the many SCAM journals; these days, they seem to publish almost exclusively poor-quality papers with misleading conclusions. It can therefore be expected that these journals will be more and more discarded by everyone (except the few SCAM advocates who publish their rubbish in them) as some sort of cult publications. In turn, this means that only SCAM studies published in mainstream journals will have the potential of generating any impact at all.

For this reason, my little survey might be relevant. It is far from conclusive, of course, yet it might provide a rough picture of what is happening in the area of SCAM research.

20 Responses to So-called alternative medicine (SCAM) in top mainstream journals from 5 different countries

  • I find this quite heartening, but it doesn’t appear to have any impact on the popularity of SCAM. After all how many members of the scammed public actually read medical journals?

    I live in an area with a strong Steiner presence so we are perhaps more exposed to pseudoscience junkies than other areas. But even otherwise intelligent friends who dismiss Steiner and all his works seem willing to believe in homeopathy, reiki and so on. One has even spent years training as a shiatsu practitioner. What it seems to give her is a complete belief system which in its way is quite disciplined and rigorous, though of course based on total nonsense.

    So it’s good to see the real medical world is no longer taking this stuff seriously but when the public no longer takes the medical world seriously ( Covid ‘fraud’? ) I doubt it will cause the SCAM business to lose sleep.

  • Just for the record… you placing Chiropractic as alternative medicine is your own wishful thinking, this is NOT how the WHO or the Chiropractic profession defines Chiropractic.

  • I have had the impression that the top journals of general medicine show less and less interest in so-called alternative medicine.

    You could get a better idea of whether this is true or not by aggregating the data across the different kinds of alt-med and the different journals; graphing it vs the year, and doing a least-squares fit of a line to the data. Excluding LTEs; a journal publishing a LTE doesn’t mean that “SCAM has made important inroads into science or medicine”.
    And if there are outliers – years where a really large number of papers on alt-med were published – it would be interesting to check whether anything special was going on, like some kind of controversy.
    Also, it might be a good idea to check whether those journals are publishing more papers in general, and maybe factor that out.

    • I agree
      so much so that I let you do the work

      • I thought you might say something like that 🙂
        Also, papers on alt-med being published in those journals doesn’t mean that “SCAM has made important inroads into science or medicine”. A lot of the papers that were published in the best journals probably came to negative conclusions.
        If those journals started having lower standards for alt-med papers than they do for regular medicine, *that* would be an inroad.

        • Also for awhile there was a push to published papers on alternative medicine. There were several reasons but in part because of the increase public use and interest in various approaches. As studies came out that didn’t support certain therapies there became a decrease need or desire to publish such findings. Some may say they now had their ammo.

          A few approaches have spark continued interest. Although I didn’t track as Ernst did per those top journals the number of papers on yoga continues to grow at a fast rate.

          I guess one could also consider it a process of trying to find wheat amongst the chaff.

  • Wow! Humans and animals have been using herbs since the beginning of time to cure and manage all sorts of conditions. Most conventional drugs have come from herbs. But EE is prepared to call herbology a scam. What arrogance! I supposed he would call mothers’ milk a scam since it didnt come from the pharmaceutical companies that he bows down to and there are no inflated controlled clinical trials made by these same companies since there is no money in it. Hook everyone up to an IV that provides everything we need and flows from big pharma and we have reached nirvana.

    • SCAM stands for so-called alternative medicine, and the acronym is written in capital letters. so you misspelled it.

      • So you are NOT trying to imply Anything by calling these treatments SCAM? Maybe you should put that at the top of every page In Bold Letters so no one will be confused like I was.

        • There’s a difference between being “confused” and being “wrong”. You were “wrong”.

          acronym [noun]: an abbreviation formed from the initial letters of other words and pronounced as a word (e.g. ASCII, NASA).

          stan [noun]: an overzealous or obsessive fan of a particular celebrity.

          — Oxford Languages

    • @stan

      Humans and animals have been using herbs since the beginning of time to cure and manage all sorts of conditions.

      You forgot to mention that most of those herbs didn’t do anything or were even harmful.

      Most conventional drugs have come from herbs.

      Of course only when those herbs actually did something therapeutic. Most herbs don’t do anything or are even harmful.

      But EE is prepared to call herbology a scam.

      Which is correct for the most part. Most herbs don’t do anything or are even harmful.

      I supposed he would call mothers’ milk a scam …

      Mammalian females have evolved to produce nutritious milk for their offspring, providing a kind of ‘superfood’ which gives the baby a head start in life. Animals have not evolved to be cured by certain herbs, nor have those herbs evolved to cure certain diseases in animals. As a matter of fact, the exact opposite regularly applies: some ‘medicinal’ herbs have evolved their active substances as a deterrent against being eaten. “Eat me, and you will have a really, really bad day.”
      But mostly, it appears to be a coincidence when a particular plant produces a substance that can be used therapeutically.

      Based on the work of Edzard and other sources(*) I’d say there are maybe a couple of dozen herbs with actual therapeutic value. And even then, one should be wary if these are prescribed by herbalists or other medically incompetent practitioners, because herbs with clear medicinal effects also tend to have side effects that may constitute a health hazard.

      *: See https://rationalwiki.org/wiki/List_of_medicinal_plants and https://medlineplus.gov/druginfo/herb_All.html

    • Wow! Humans and animals have been using herbs since the beginning of time to cure and manage all sorts of conditions.

      @stan, my man! You and I are thinking on the same wavelength Bro! What EE & Co. don’t understand is that ancient remedies need not be researched. We don’t need a fancy professor from a big-pharma funded university to tell you what you can and cannot use as a remedy. Ancient remedies have already been researched and tested by generations before us and that is all the evidence we need.

      Herbology is a great example of. But, you know what else humans have been using as remedy for generations? Cow dung and urine, in India. Indians are great at harvesting ancient wisdom to make their lives better without the help of big-pharma. For example, they have a hand sanitizer made from cow urine: https://www.youtube.com/watch?v=s8CuDI__lgA&t=132s, to keep covid away without pharma chemicals. How amazing is that? I recommend watching that video in its entirety to understand how cowpathy is used in India.

      Western nations are certainly approaching nirvana with pharma drugs, like you mentioned. On the other hand, India is approaching nirvana with cowpathy using naturally available materials. I dream of a day when Western nations embrace ancient wisdoms like cowpathy. I hope, one day we will all be running around with cow dung smeared on our faces (instead of pharma IVs): https://www.youtube.com/watch?v=AnR6tNSLbOw

  • The author Axel Wehrend is a member of the board of the German Veterinary Association, the association of academic veterinarians in Germany. He would have a position there to actively counter all the pseudo-medical nonsense, but I know nothing about that.

    The journal of the veterinary association, the “Deutsche Tierärzteblatt” (German Veterinary Journal), published an article not long ago massively promoting homoeopathy, where it was praised beyond all measure as “regulatory medicine”. As if this was not enough (the article referred to a publication by Weiermayer, Frass et al. in the Swiss “Archiv Tiermedizin”; the official veterinary journal there), the “Tierärzteblatt” topped this off with an introductory editorial written by Mr Wehrend’s board colleague Heidi Kübler, who herself is also chairperson of the German “Gesellschaft für ganzheitliche Tiermedizin” (Society for Holistic Veterinary Medicine).

    Any questions?

    By the way, interventions and letters to the editor from the Germsn INH (Information Network Homeopathy) are persistently ignored. Veterinary medicine seems to be becoming a fortress for homeopathy in the German-speaking world, after 12 of 17 medical associations in human medicine have said goodbye to homeopathy as the content of further training and qualifications.

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