bias
A recent article about ayurvedic medicine caught my eye. Here are a few excerpts:
Imagine if there were a magic pill to ward off COVID-19. Or if you could cure diabetes with vegetable juices and herbal pills instead of controlling it with insulin medication. Or if yoga and breathing exercises were all you need to do to get rid of asthma. These are all claims made by Patanjali Ayurved, one of India’s biggest manufacturers of traditional ayurvedic products…
Many scientists have expressed concerns over the lack of research into the safety and efficacy of ayurvedic products… Nonetheless, Ayurveda enjoys widespread acceptance among Indians. And under India’s Hindu-nationalist government that took power in 2014, ayurveda and other alternative systems of medicine have received unprecedented government support. India’s ministry of alternative medicine gets nearly $500 million a year. The government also promotes ayurveda through its international trade and diplomatic channels. All this set Patanjali’s fortunes soaring.
But now the Supreme Court of India has temporarily banned Patanjali – named after a Hindu mystic best known for his writings on yoga – from advertising some of its products… “The entire country has been taken for a ride,” Ahsanuddin Amanullah, one of the two judges conducting the court hearing, told the lawyer representing the government… The Indian Medical Association had brought the case to court in August 2022, claiming that Patanjali and its brand ambassador Baba Ramdev made a series of false claims against evidence-backed modern medicine and its practitioners, and spread misinformation about COVID-19 vaccines. Their petition also referred to instances where Ramdev lambasted modern medicine as a “stupid and bankrupt science” at a yoga session. The trigger was a series of Patanjali advertisements in Indian newspapers in July 2022 claiming that ayurvedic products could cure chronic conditions like diabetes, high blood pressure, heart diseases and autoimmune conditions. The Indian Medical Association’s petition alleged that such claims were in violation of India’s Drugs and Magic Remedies (Objectionable Advertisements) Act.
…The company’s public face – yoga guru Baba Ramdev – is a vocal supporter of India’s ruling party, the BJP, and Prime Minister Narendra Modi. Modi even inaugurated Patanjali’s ayurvedic research facility in 2017… Some scientists have accused their government of promoting these alternative medicines at the expense of modern medicine, partly as a way to glorify India’s culture and history. “One of the political ideas of this government is to glorify the Hindu tradition,” says Dhrubajyoti Mukherjee, president of the Breakthrough Science Society, an organization that promotes scientific thinking. “But in the name of our glorious past, the government is propagating obscure, unscientific ideas.”
… A few months after the outbreak of the COVID-19 pandemic in 2020, India’s health minister at the time, Harsh Vardhan participated in the company’s launch of pills, where Ramdev, the yoga guru, claimed the pills showed “100 percent favorable results” during clinical trials on patients. Despite experts flagging the lack of evidence, the company said it sold 2.5 million kits in six months, consisting of the tablets to ward off COVID-19 and bottled oils that would allegedly boost immunity. And the company is making an enormous amount of money: Its income was over $1.3 billion in the financial year 2021-22, with profits of $74 million before taxes.
Addressing the overall impact of misinformation about ayurvedic treatments, Dr. Jayesh Lele, vice president of the Indian Medical Association, says “Our worry is people are being misguided. We have got people who’ve left our treatment saying their kidneys will be able to function properly [using ayurvedic medicines] and ended up with renal failure. The same happened with patients suffering from hepatitis, who’ve got the wrong medicine and ended up with further problems. And if you say every day that modern medicine is bad, that is not acceptable.”
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The sad thing, in my view, is that (as discussed previously) ayurvedic medicine has not just taken India for a ride:
- King Charles’ “Ayurvedic Centre of Excellence” turns out to be an embarrassing failure
- Dr Michael Dixon seems to support homeopathy as a treatment for cancer
- PRINCE CHARLES: the ‘immense value’ of alternative diagnostic methods
- Will the UK ‘ROYAL COLLEGE OF GENERAL PRACTITIONERS’ soon become a ‘ROYAL COLLEGE OF QUACKERY’?
And perhaps even more disappointing is the notion that, while in India they take action in order to prevent harm, I can see no such developments in the UK.
According to its authors, this study‘s objective was to demonstrate that acupuncture is beneficial for decreasing the risk of ischaemic stroke in patients with rheumatoid arthritis (RA).
The investigation was designed as a propensity score-matched cohort nationwide population-based study. Patients with RA diagnosed between 1 January 1997 and 31 December 2010, through the National Health Insurance Research Database in Taiwan. Patients who were administered acupuncture therapy from the initial date of RA diagnosis to 31 December 2010 were included in the acupuncture cohort. Patients who did not receive acupuncture treatment during the same time interval constituted the no-acupuncture cohort. A Cox regression model was used to adjust for age, sex, comorbidities, and types of drugs used. The researchers compared the subhazard ratios (SHRs) of ischaemic stroke between these two cohorts through competing-risks regression models.
After 1:1 propensity score matching, a total of 23 226 patients with newly diagnosed RA were equally subgrouped into acupuncture cohort or no-acupuncture cohort according to their use of acupuncture. The basic characteristics of these patients were similar. A lower cumulative incidence of ischaemic stroke was found in the acupuncture cohort (log-rank test, p<0.001; immortal time (period from initial diagnosis of RA to index date) 1065 days; mean number of acupuncture visits 9.83. In the end, 341 patients in the acupuncture cohort (5.95 per 1000 person-years) and 605 patients in the no-acupuncture cohort (12.4 per 1000 person-years) experienced ischaemic stroke (adjusted SHR 0.57, 95% CI 0.50 to 0.65). The advantage of lowering ischaemic stroke incidence through acupuncture therapy in RA patients was independent of sex, age, types of drugs used, and comorbidities.
The authors concluded that this study showed the beneficial effect of acupuncture in reducing the incidence of ischaemic stroke in patients with RA.
It seems obvious that the editors of ‘BMJ Open’, the peer reviewers of the study and the authors are unaware of the fact that the objective of such an investigeation is not to to demonstrate that acupuncture is beneficial but to test whether acupuncture is beneficial. Starting a study with the intention to to show that my pet therapy works is akin to saying: “I am intending to mislead you about the value of my intervention”.
One needs therefore not be surprised that the authors of the present study draw very definitive conclusions, such as “acupuncture therapy is beneficial for ischaemic stroke prevention”. But every 1st year medical or science student should know that correlation is not the same as causation. What the study does, in fact, show is an association between acupuncture and stroke. This association might be due to dozens of factors that the ‘propensity score matching’ could not control. To conclude that the results prove a cause effect relationship is naive bordering on scientific misconduct. I find it most disappointing that such a paper can pass all the hurdles to get published in what pretends to be a respectable journal.
Personally, I intend to use this study as a good example for drawing the wrong conclusions on seemingly rigorous research.
There are many variations of acupuncture. Electroacupuncture (EA) and Laseracupuncture (LA) are but two examples both of which are commonly used. However, it remains uncertain whether LA is as effective as EA. This study aimed to compare EA and LA head to head in dysmenorrhea.
A crossover, randomized clinical trial was conducted. EA or LA was applied to selected acupuncture points. Participants were randomized into two sequence treatment groups who received either EA or LA twice per week in luteal phase for 3 months followed by 2-month washout, then shifted to other groups (sequence 1: EA > LA; sequence 2: LA > EA). Outcome measures were heart rate variability (HRV), prostaglandins (PGs), pain, and quality-of-life (QoL) assessment (QoL-SF12). We also compared the effect of EA and LA in low and high LF/HF (low frequency/high frequency) status.
43 participants completed all treatments. Both EA and LA significantly improved HRV activity and were effective in reducing pain (Visual Analog Scale [VAS]; EA: p < 0.001 and LA: p = 0.010) and improving QoL (SF12: EA: p < 0.001, LA, p = 0.017); although without intergroup difference. EA reduced PGs significantly (p < 0.001; δ p = 0.068). In low LF/HF, EA had stronger effects than LA in increasing parasympathetic tone in respect of percentage of successive RR intervals that differ by more than 50 ms (pNN50; p = 0.053) and very low-frequency band (VLF; p = 0.035).
The authors concluded that there is no significant difference between EA and LA in improving autonomic nervous system dysfunction, pain, and QoL in dysmenorrhea. EA is prominent in PGs changing and preserving vagus tone in low LF/HF; yet LA is noninvasive for those who have needle phobia. Whether LA is equivalent with EA and the mechanism warrants further study.
Looking at the affiliations of the authors, one might expect that they should be able to design a meaningful study:
- 1Division of Hemato-Oncology, Department of Internal Medicine, Branch of Zhong-Zhou, Taipei City Hospital, Taipei, Taiwan.
- 2Institute of Traditional Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan.
- 3Department of Traditional Medicine, Branch of Yang-Ming, Taipei City Hospital, Taipei, Taiwan.
- 4Department of Traditional Medicine, Branch of Kunming, Taipei City Hospital, Taipei, Taiwan.
- 5Department of Gynecology and Obstetrics, Branch of Yang-Ming, Taipei City Hospital, Taipei, Taiwan.
Sadly, this assumption is evidently mistaken.
The trial certainly does not show what they claim and neither had it ever the chance to show anything relevent. A clinical trial is comparable to a mathematical equation. It can be solved, if it has one unkown; it cannot produce a result, if it has two unknowns.
The efficacy of EA and LA for dysmenorrhea are both unknown. A comparative study with two unknowns cannot produce a meaningful result. EA and LA did not both improve autonomic nervous system dysfunction, pain, and QoL in dysmenorrhea but most likely they both had no effect. What caused the improvement was not the treatment per se but the ritual, the placebo effect, the TLC or other non-specific factors. The maginal differences in other parameters are meaningless; they are due to the fact that – as an equivalence trial – the study was woefully underpowered and thus open to coincidental differences.
Clinical trials should be about contributing to our knowledge and not about contributing to confusion.
Here is the abstract of a recent article that I find worrying:
In 2020, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) challenged the world with a global outbreak that led to millions of deaths worldwide. Coronavirus disease 2019 (COVID-19) is the symptomatic manifestation of this virus, which can range from flu-like symptoms to utter clinical complications and even death. Since there was no clear medicine that could tackle this infection or lower its complications with minimal adverse effects on the patients’ health, the world health organization (WHO) developed awareness programs to lower the infection rate and limit the fast spread of this virus. Although vaccines have been developed as preventative tools, people still prefer going back to traditional herbal medicine, which provides remarkable health benefits that can either prevent the viral infection or limit the progression of severe symptoms through different mechanistic pathways with relatively insignificant side effects. This comprehensive review provides scientific evidence elucidating the effect of 10 different plants against SARS-CoV-2, paving the way for further studies to reconsider plant-based extracts, rich in bioactive compounds, into more advanced clinical assessments in order to identify their impact on patients suffering from COVID-19.
The conclusions of this paper read as follows:
…since these 10 herbs hold distinct bioactive compounds with significant properties in vitro and with remarkable benefits to human health, it is possible to prevent SARS-CoV-2 infection and reduce its symptomatic manifestations by consuming any of these 10 plants according to the recommended dose. The diversity in bioactive molecules between the different plants exerts various effects through different mechanisms at once, which makes it more potent than conventional synthetic drugs. Nonetheless, more studies are needed to highlight the clinical efficacy of these extracts and spot their possible side effects on patients, especially those with comorbidities who take multiple conventional drugs.
I should point out that the authors fail to offer a single reliable trial that would prove or even imply that any of the 10 herbal remedies can effectively treat or prevent COVID infections (to the best of my knowledge, no such studies exist). Laguage like “it is possible to prevent SARS-CoV-2 infection and reduce its symptomatic manifestations” is therefore not just misleading but highly dangerous and deeply unethical. Sadly, such evidence-free claims abound in herbal medicine.
I think the journal editor, the peer-reviewer, the authors and their universities ( University of Tripoli in Lebanon, American University of the Middle East, Egaila in Kuwait, University of Balamand, Kalhat, Tripoli in Lebanon, Lebanese University, Tripoli in Lebanon, Aix-Marseille Université in France) should be ashamed to produce such dangerous rubbish.
Acute Otitis Media (AOM) is one of the most common acute infections in children and often injudiciously treated by antibiotics. Homeopathy has been claimed to work but is it really effective?
This open label, randomized, controlled, parallel arm trial was conducted on children (aged 0–12 years), suffering from AOM. The primary outcome was changes in Tympanic Membrane Examination scale (TMES) and Acute Otitis Media-Severity of Symptoms (AOM-SOS) scale, time to improvement in pain through Facial Pain Scale-Revised (FPS-R) over 10 days. The need for antibiotics in both groups and the recurrence of subsequent episodes of AOM over 12 months were also compared.
Intention-to-treat analysis was performed on 222 children; Homeopathy (n = 117) (H-group), Allopathy (A-group) (n = 105). There was a statistically significant reduction of scores in H-group compared with A-group at each time point: at day 3 (mean diff. ± sd: 1.71 ± 0.19; 95% CI: 1.34 to 2.07; p = 0.0001), at day 7 (mean diff. ± sd: 1.29 ± 0.24; 95% CI: 0.82 to 1.76; p = 0.0001) and at day 10 (mean diff. ± sd: 1.23 ± 0.25; 95% CI = 0.74 to 1.71; p = 0.0001) favoring homeopathy. Clinical failure by the third day of treatment was observed in 11% and 24% of children in H-group vs A-group (OR: 0.03; 95% CI: 0.001 to 0.52; p = 0.03). None of the children in the H-group required antibiotics, whereas 14 children in the A-group did.
The authors concluded that both therapies seemed to produce comparable effects and appeared safe. The study consolidated the findings observed during a pilot study, i.e., homeopathy is non-inferior to allopathy in managing AOM in children and antibiotics in children can be avoided.
This study was published in the journal ‘Homeopathy’ and originates from the Central Council for Research in Homeopathy, New Delhi, India. Sadly, I do not have the full text of the paper and cannot therefore scrutinize it adequately.
Let me just mention these three facts:
- The journal ‘Homeopathy’ never publishes negative results.
- Indian researchers of homeopathy publish as good as no negative results.
- As far as I can see, the Central Council for Research in Homeopathy, New Delhi, has never published a negative result.
These points do, of course, not necessarily mean that the study is false-positive, but they do not inspire me with confidence. In any case, it seems wise to insist on better evidence. To render it credible, we would need:
- Several rigorous RCTs that test homeopathy for AOM against placebo.
- If (and only then) they show that homeopathy is better than placebo, at least one independent replication of the present study.
As the biological plausibility of all this is close to zero, the chances that this will happen are also zero.
I have left the German skeptics organisation , GWUP, two days ago. This led to many questions and confusion. I therefore feel that I owe it to those skeptics who I may have upset or unsettled to offer a few clarifications (I do appologise, if this does not make much sense to those readers who were unable to follow the various disputes and discussions that took place, mostly in German, on Twitter).
1. Clarification – accusation of antisemitism: This accusation is completely absurd! In my opinion, the 1st re-Tweet that Bartoschek is using is not anti-Semitic. I have posted thousands of tweets, many of which are the opposite of anti-Semitic, as anyone can verify. Moreover, I have worked for the last 30 years to fight antisemitism and can probably show more results of this endeavor than my accuser.
2. Clarification – I can’t find the 2nd re-tweet that Bartoschek exhibits. No idea who found it and where! I can’t remember the text (but I do vaguely remember the graphic), and I certainly didn’t delete anything. I would delete if, if I could find it and be open about it. If it turns out that I am nevertheless at fault, I can only apologise.
3. Clarification – peer-review publications by Hirsch, Huemmler, Bartoschek (who I sarcastically called ‘the GWUP-elite’). After watching a long video of these gentlemen, I began to doubt whether they are true scientists (or even skeptics) at all. Hence my legitimate question. The answer seems to be largely negative.
4. Clarification – Bartoschek claims “Prof Ernst is on the side of the “anti-woke”. However, I have repeatedly emphasised that I do not believe in and even detest both ‘woke’ and ‘anti-woke’.
5. Clarification – Mr Hirsch is the ‘social media manager’ of the GWUP commissioned by Huemmler, the current chair of the GWUP. The fact that he spreads aggressive nonsense in this role under the pseudonym ‘Endgegner der Kommentarspalten’ is inadmissible.
6. Clarification – I have not gained the impression that the current division of the GWUP is primarily idiological in nature (both sides are not far apart in this respect), but believe that it is a rather ridiculous power struggle on a personal level.
7. Clarification – I have left the GWUP because I am sure that I can do my work better without it, because the current tone amongst GWUP members is unacceptable, because the GWUP is currently not converting its membership fees (I estimate ~200 000 per year) into meaningful activities, because the current GWUP ‘elite’ behaves neither as genuine sceptics nor as true scientists, and because I fear that things will only get worse after the AGM in May.
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My hope is that this is the last time I have to mention this sorry story here on my blog.
The 29th of February is an unusual date, and I will do something fittingly unusual today – something that I have never done before: I will with a heavy heart resign from an organisation of skeptics.
After I had observed the self-destructive debates within the GWUP for almost one year without saying a single word about it (hoping they would soon dissolve into thin air), I published a comment a few days ago. Soon after, I was aggressed, defamed, wrongly denounced as an anti-Semite, and blackmailed by leading members of that organisation.
Confronted with these events, it was inevitable that I would have doubts about my previous plan to remain a member until the upcoming general assembly in May. While I was contemplating, I received a Tweet on 27/2/2024 from someone under the pseudonym Endgegner der Kommentarspalten; it included this sentence:
Einer der verschwörungsideologischen Clowns, die seit gut einem Jahr Kulturkrieg in der GWUP mit rechtsextremen Talking Points spielen und Märchen von einem “woken Putsch” herbeiphantasieren?
My translation:
One of the conspiracy ideological clowns who have been playing culture war in the GWUP for a good year with right-wing extremist talking points and fantasising about a “woke coup”?
Next, I watched a long discussion on youtube between the new chair of the GWUP, my accuser (Bartoschek) and Sebastian Hirsch. There I learnt that the latter is, in fact, nobody else than Endgegner der Kommentarspalten. He was recently put in charge of Twitter account for GWUP by the chair.
At this point, I lost the hope that the GWUP might be saved. It seems to be in the hand of thugs who call not me personally but their opponents ‘ideological clowns who have been playing culture war’. They claim that they want to keep politics out of the GWUP, yet almost all they do is engaging in politics.
Since the former formidable chair, Amardeo Sarma, left and the rift started, the GWUP has done nothing wothwhile, as far as I can see. On the GWUP website, we are told that (my translation):
- The GWUP aims at promoting science and scientific thinking.
- The GWUP investigates parascientific theories according to the current state of scientific knowledge and reports publicly and comprehensibly on its findings.
- The GWUP aims to disseminate scientific and critical thinking and scientific methods, explain them in a generally understandable way and clearly distinguish real science from parascience. The GWUP thus wants to contribute to reducing society’s susceptibility to parascientific ideas and promises.
- The GWUP is an internationally orientated society. It is happy to work with like-minded individuals, organisations and institutions.
GWUP stands for ‘Gesellschaft zur wissenschaftlichen Untersuchung von Parawissenschaften’ (Society for the Scientific Investigation of Parasciences). The people currently in charge claim to be scientists but most of them are not (talking about science or publishing books for the lay reader about it does not, in my view, make you a scientist!). The leadership of the GWUP, it seems to me, is currently dominated by small-minded inward-looking guys with no international perspective who are in the middle of a mega-ego trip.
Instead of fighting parascience, they feel entitled to fight their colleagues. Instead of doing their job, they open the door to parascience. Instead of being scientists, they are using skepticism as an excuse for their machinations. Instead of running a scientific organisation, they turned it into a veritable kindergarden. In a nutshell: to the utmost delight of German parascientists, they have completely lost the plot.
I do not believe that the general assembly can turn things around. More likely, matters will get worse and it will come to a complete split. Personally, I cannot – not even until May – remain a member of an organisation where the man officially put in charge of the Twitter account feels entitled to collectively call his opponents ‘ideological clowns who have been playing culture war’. This remark in itself might not be all that significant but, for me, it is the ‘last straw’ and a symptom of a deep and irreversible rot.
So, I have come to the conclusion that I can do my work better without any further GWUP-hindrance. Therefore, I will now email my resignation as a member of the GWUP.
Jennifer Jacobs started publishing peer-reviewed papers on homeopathy in the early 1990s. This happens to be around the same time as I did. So, we both have about 30 years of research into homeopathy behind us.
Jennifer just authored a paper entitled “Thirty Years of Homeopathic Research – Lessons Learned“. Here is its abstract:
Conducting double-blind randomized controlled trials is difficult, even in the allopathic medical system. Doing so within the paradigm of classical homeopathy is even more challenging. More than thirty years of experience in carrying out such trials has taught me much about the pitfalls to avoid as well as the factors that can lead to success. The initial steps of putting together a research protocol, securing funding, and obtaining human subjects’ approval can be daunting. After that comes developing questionnaires and surveys, hiring study personnel, and recruitment of subjects. The actual implementation of the research comes with its own set of possible missteps. Sample size determination, entry criteria, as well as type, frequency and duration of treatment are all crucial. Finally, statistical analysis must be performed to a high standard and a manuscript prepared to submit for publication. Even then there can be one or more manuscript revisions to make, based on feedback from reviewers, before a study is actually published. The entire process can take at least two years and is usually much longer.
Mistakes at any one of these steps can damage the outcome, as well as the impact of the study. With examples from my body of research, I will discuss some of the things that I wish I had done differently, as well as those that turned out to be correct. Homeopathic research is held to a much higher standard than conventional trials. Any flaws in study design, implementation, and analysis can be used by critics to negate the results. I am hopeful that the next generation of homeopathic researchers will learn from my experiences and carry on with great success.
Jennifer’s example motivated me to follow suit and contribute some very brief thoughts about my 30 years of homeopathy research and the lessons I have learnt:
Conducting double-blind randomized controlled trials is difficult in any area of medicine. Yet these types of studies are by far the best way to find out which treatments work and which don’t. Therefore, they need doing, regardless of the obstacles they may pose.
In homeopathy, we now have a large body of such trials. Sadly, not all of them are reliable. Those that are, according to accepted criteria, tend to fail to show that homeopathy works better than a placebo. Understandably, homeopaths are disappointed with this overall result and have made numerous attempts to invalidate it.
The main problem with research into homeopathy is not the research methodology. It is well established for clinical trials and can be easily modified to fit all the demands made by individualised treatment or other pecularities that may apply to homeopathy. The main problem is the homeopath who finds it impossible to accept the truth, namely that highly diluted homeopathic remedies are pure placebos and any observed benefits of homeopathy are due to non-specific effects such as the empathetic encounter or a placebo response.
The lesson to be learned from the past is that, in medicine, even the most obsessive belief, conviction or wishful thinking will eventually have to give way to the scientific evidence. In the case of homeopathy, this process has taken an extraordinary amount of time and effort but, finally, we are almost there and the writing is on the wall for everyone to see.
Two resumes of 30 years of work, research and experience!
And what a difference between them!
Who do you think gets closer to the truth,
Jennifer or I?
Of all the forms of so-called alternative medicine (SCAM), Reiki is amongst the least plausible. It is a form of paranormal or ‘energy healing’ popularised by Japanese Mikao Usui (1865–1926). Reiki is based on the assumptions of Traditional Chinese Medicine and the existence of ‘chi’, the life-force that is assumed to determine our health.
Reiki practitioners believe that, with their hands-on healing method, they can transfer ‘healing energy’ to a patient which, in turn, stimulates the self-healing properties of the body. They assume that the therapeutic effects of this technique are obtained from a ‘universal life energy’ that provides strength, harmony, and balance to the body and mind.
Despite its implausibility, Reiki is used for a very wide range of conditions. Some people are even convinced that it has positive effects on sexuality. But is that really so?
This randomised clinical trial was aimed at finding out. Specifically, its authors wanted to determine the effect of Reiki on sexual function and sexual self-confidence in women with sexual distress*. It was was conducted with women between the ages of 15–49 years who were registered at a family health center in the eastern region of Turkey and had sexual distress.
The sample of the study consisted of 106 women, 53 in the experimental group and 53 in the control group. Women in the experimental group received Reiki once a week for four weeks, while no intervention was applied to those in the control group. Data were collected using the Female Sexual Distress Scale-Revised (FSDS-R), the Arizona Sexual Experiences Scale (ASEX), and the Sexual Self-confidence Scale (SSS).
The levels of sexual distress, sexual function, and sexual self-confidence of women in both groups were similar before the intervention, and the difference between the groups was not statistically significant (p > 0.05). After the Reiki application, the FSDS-R and ASEX mean scores of women in the experimental group significantly decreased, while their SSS mean score significantly increased, and the difference between the groups was statistically significant (p < 0.05).
The authors concluded that Reiki was associated with reduced sexual distress, positive outcomes in sexual functions, and increase sexual self-confidence in women with sexual distress. Healthcare professionals may find Reiki to positively enhance women’s sexuality.
Convinced?
I hope not!
The study has the most obvious of all design flaws: it does not control for a placebo effect, nor the effect of empaty/sympathy received from the therapist, nor the negative impact of learning that you are in the control group and will thus not receive any treatment or attention.
To me, it is obvious that these three factors combined must be able to bring about the observed outcomes. Therefore, I suggest to re-write the conclusions as follows:
The intervention was associated with reduced sexual distress, positive outcomes in sexual functions, and increase sexual self-confidence in women with sexual distress. Considering the biological plausibility of a specific effect of Reiki, the most likely cause for the outcome are non-specific effects of the ritual.
*[Sexual distress refers to persistent, recurrent problems with sexual response, desire, orgasm or pain that distress you or strain your relationship with your partner. Yes, I had to look up the definition of that diagnosis.]
Yes, I often moan about the abundance of poor-quality prevalence surveys that we are confronted with when scanning the literaturee on so-called alternative medicine (SCAM), e.g.:
- The survey mania in so-called alternative medicine prevents progress
- A truly homeopathic survey
- A new survey of CAM-use (or is it a promotion for more nonsense on the NHS?)
- A new chiropractic survey seems to avoid all the potentially embarrassing questions
- Survey-mania in alternative medicine: a fruitless, misleading and counter-productive distraction
Here is another example that recently appeared on my screen and that allows me to explain (yet again) why these surveys are such a waste of space:
The Use of Traditional and Complementary Medicine Among Patients With Multiple Sclerosis in Morocco
Let’s assume the survey is done perfectly (a condition that most are very far from meeting). If the information generated by such a perfect survey were worthwhile, we would also need to consider possible mutations that would be just as relevant:
- We have just over 200 nations (other than Morocco) on the planet.
- I assume there are about 1000 conditions (other than multiple sclerosis) for which SCAM is used.
- There are, I estimate, 100 different definitions of SCAM (other than ‘traditional and complementary medicine’) that all include different modalities.
So, this alone would make 20 000 000 surveys that would be important enough to get published. But that’s not all. The usage and nature of SCAM change fairly quickly. That means we would need these 20 million surveys to be repeated every 2 to 3 years to be up-to-date.
For all this, we would need, I estimate, 200 000 research groups doing the work and about 20 000 SCAM journals to publish their results.
I think we can agree that this would be a nonsensical effort for producing millions of papers reaching dramatic conclusions that read something like this:
Our survey shows that patients suffering from xy living in yz use much SCAM. This level of popularity suggests that SCAM is much appreciated and needs to be made available more widely and free of charge.
I rest my case.
