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

On 20/1/2023, I conducted multiple Medline searches aimed at generating a rough idea about which areas of so-called alternative medicine (SCAM) are currently more research active than others. I searched for:

  1. the topic in question
  2. clinical trial
  3. publication in 2023

Here are my findings (subject area and the number of hits):

  • TCM 56
  • dietary supplements 47
  • acupuncture 34
  • integrative medicine 27
  • mindfulness 26
  • herbal medicine 23
  • massage 10
  • aromatherapy 2
  • hypnotherapy 2
  • osteopathy 2
  • tai chi 2
  • chiropractic 1
  • homeopathy 0
  • iridology 0
  • naturopathy 0
  • Reiki 0

Several caveats must be considered, of course: The searches do not include all SCAMs. The results are not precise and most of the retrieved articles are not really clinical trials (in fact, only a minority are). The numbers are low because I deliberately did this exercise early in the year.

Yet, the findings do, I think, give an indication as to the current state of SCAM research and indicate which areas are more research active than others. To put the numbers in perspective, here are a few conventional therapies for which I searched on the same day and in the same manner:

  • pharmacology 539
  • physiotherapy 162
  • psychiatry 239
  • surgery 879

I think this makes one point fairly clear: SCAM is not an impressively research-active area. Another point stems from looking at the individual articles. TCM and acupuncture articles are almost exclusively authored by Chinese researchers. While this might not be surprising, the fact that herbal medicine is similar did amaze me; about half of the papers in this category are by Chinese authors. Essentially, this suggests that more than half of the SCAM articles currently originate from China. Considering the concerns one must have about Chinese SCAM research (see for instance here and here), do you think this finding might be worrying?

The far greater worry, I feel, is the attitude of the SCAM researchers publishing their work. Glancing at these papers I did not get the impression that many approached their subject critically, In fact, most of the papers looked to me overtly promotional and of poor quality. For instance, I did not see a single paper assessing the risks of SCAM which arguably is the most important issue in SCAM research. I admit that these concerns cannot be addressed by the above simple head count; they are best dealt with by critically analyzing individual studies – a task I regularly try to tackle on this blog

 

19 Responses to My concerns about the current research activity in so-called alternative medicine (SCAM)

  • Glancing at these papers I did not get the impression that many approached their subject critically, In fact, most of the papers looked to me overtly promotional and of poor quality.

    This sort of thing has been noted before, for example:

    The motivation for doing trials seems less to be innovation or self-critical evaluation of performance (which is generally considered to be the motivation for good research) but rather justification in front of a hostile scientific establishment.

    Linde K, Melchart D (1998). Randomized controlled trials of individualized homeopathy: a state-of-the-art review. J Altern Complement Med, Winter 1998;4(4):371-88

  • What qualifies physiotherapy to be listed as a conventional therapy?

    • The fact that it is widely used and accepted by most health professionals.
      “Conventional treatment or Conventional therapy is the therapy that is widely used and accepted by most health professionals. It is different from alternative therapies, which are not as widely used.”
      https://en.wikipedia.org/wiki/Conventional_treatment#:~:text=Conventional%20treatment%20or%20Conventional%20therapy%20is%20the%20therapy,for%20cancer%20include%20surgery%2C%20chemotherapy%20and%20radiation%20therapy.

      • “Treatments that are widely accepted and practiced by the mainstream medical community.”

        Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights reserved.

        I didn’t know the mainstream medical community widely practiced physiotherapy. I thought they tend to refer that stuff out to PTs.

        • “Didn’t know”…”thought”…

          Physiotherapy is an important part of modern holistic healthcare. For example we have physiotherapists in our hospitals working with patients in orthopedics, ICU, surgery, rehaabilitation and so forth. On the other hand we have zero chiropractors, herbalists, osteopaths, homeopaths, acupuncturists….
          Your homework is to try to figure out why the physiotherapists are an important part of the modern medical team and why some other wannabe practitioners are not in demand.

          • In Vienna I employed ~60 physios in my department.

          • “Although many physical therapists practice in hospitals, more than 80% practice in other settings, according to the American Physical Therapy Association (APTA).”

            https://explorehealthcareers.org/career/physical-therapy/physical-therapist/

            Comes down to definitions.

            mainstream medical community

            Just seems strange to list physiotherapy along side pharmacology and surgery.

          • “Although many physical therapists practice in hospitals, more than 80% practice in other settings, according to the American Physical Therapy Association (APTA).”
            I have good news for you: there are other countries besides the US in this world.

          • “Just seems strange to list physiotherapy along side pharmacology and surgery.”
            are you sure that your reason for going on about this triviality is not to distract from the real point of my blog?

          • The real point?

            How about considering there are approximately:

            6 million MDs
            1.5 million PTs
            100,000 chiropractors

            pharmaceutical research covers every known disease to humans
            chiropractic research covers mainly two conditions…nsNP and nsLBP

            Hmmm, would that affect the number of publishing clinical trials?

            1000s of MD (pharmaceutical directed) journals
            two primary chiropractic journals of which one is published quarterly

            sure chiropractors need to pick up the game on clinical research. But your little comparison above doesn’t cover several factors.

          • “chiropractic research covers mainly two conditions…nsNP and nsLBP”
            not according to the loon who invented your SCAM!

          • EE: not according to the loon who invented your SCAM!

            The topic is recent research, not what someone said or thought 125 years ago.

          • even recent chiro research is not “mainly two conditions…nsNP and nsLBP”
            But thanks for confirming that chiro is based on a loon’s imagination

          • actually, it appears he based his views mainly on correlation and mistook it for causation. Not uncommon for that time period.

          • It appears chrios these days still can’t differentiate between correlation and causation. Below is a typical example:

            https://draxe.com/health/what-is-a-chiropractor/#Top_7_Benefits_of_Chiropractic

            One of the biggest challenges that Chiropractors face is the public’s perception of Chiropractic. Many still believe that the benefits of chiropractic adjustments are limited to back and neck pain relief. But that is just a small portion of the benefits that chiropractic care delivers. Some of the greatest evidence today shows exactly why Chiropractors have been seeing amazing results in their offices, each week, for over 120 years, with symptoms and conditions seemingly unrelated to the spine.
            It all comes back to how Chiropractic positively influences the nervous system. From improved breathing and digestion, to increased immunity, better organ function, fertility and so much more, we now know from a scientific and research standpoint how adjustments can have such far-reaching benefits.

            https://draxe.com/health/chiropractic-care-and-autism/

            A chiropractor can help children with autism by improving neurological function. The autonomic nervous system of the body is designed to protect people with certain automatic responses. A common response is the “fight or flight” mode. When sensing danger, the body locks out all other stimuli to make the decision to fight or flee. Sometimes, due to a misaligned spine, the mind gets stuck in this mode, frozen, if you will, leaving the person unable to respond.
            Most sensory activity is located along the spinal column. Chiropractic care improves the processing of information, like the highway we mentioned earlier, by allowing communication to flow freely.
            When you adjust the structure of the body, it often leads to very real, long-lasting results without drugs, without surgery.It’s why chiropractic adjustments are considered part of a natural treatment regimen for autism.

            Bolding mine.

          • Thank goodness for ‘chiropractic research’:
            https://commons.m.wikimedia.org/wiki/File:Dr._Heidi_Bockhold_Adjusts_Horse.jpg

            Unfortunate one has to interview chiropractors to find a good one.

            ‘DC’ on Twenty Things Most Chiropractors Won’t Tell You

          • once again Pete adds nothing to the topic/s at hand.

          • I echo Björn’s comment to ‘DC’:

            “Didn’t know”…”thought”…

            Physiotherapy is an important part of modern holistic healthcare. For example we have physiotherapists in our hospitals working with patients in orthopedics, ICU, surgery, rehaabilitation and so forth. On the other hand we have zero chiropractors, herbalists, osteopaths, homeopaths, acupuncturists….

            Your homework is to try to figure out why the physiotherapists are an important part of the modern medical team and why some other wannabe practitioners are not in demand.

          • Talker: It appears chrios these days still can’t differentiate between correlation and causation.

            Yep, some of them. But that’s not unique to chiropractors.

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