panacea
Quackademia, a term created [as far as I remember] by David Colquhoun for the infiltration of quackery into academia, has often been discussed on this blog, e.g.:
- Quackademia in Canada: the first bachelor’s degree in Traditional Chinese Medicine
- Quackademia galore: An Oxford ‘university’ starts a course in ‘veterinary chiropractic’
- Quackademia at its most rampant: the ‘Certificate in Holistic Health and Healing Arts’ (HHHA) at the University of New Mexico
- Another blow to quackademia: TCM course at a Sydney university is to be stopped
- Vienna 2019: the end of quackademia
- Quackademia down under
- Quackademia revisited
- Quackademia
Now growing backlash against quackademia seems to finally emerge also in France – opposition against university programs that give academic legitimacy to unproven so-called alternative medicine (SCAM). The Higher Council for the Evaluation of Research and Higher Education is preparing to review these courses, after criticism that universities are lending credibility to practices that have not been scientifically validated.
Across France, more than 200 university diplomas are said to exist in areas such as reflexology, aromatherapy, auriculotherapy, hypnosis, acupuncture, homeopathy, meditation, and related practices. Critics argue that this amounts to a form of institutional “entryism,” because the university label can make such practices look medically endorsed even when they are not.
The main concern is not just whether these therapies work, but whether universities should be teaching them at all. A January report on health misinformation reportedly recommended banning the academic labeling of healthcare practices that have not been validated, and that recommendation is at the center of the debate. Experts warn that, if a SCAM is scientifically validated, it belongs in medicine; if it is not, it may still be studied, but should not be taught as an academic medical qualification. They also warn that these programs can mislead the public and create a false impression of legitimacy. Yet, some deans and faculty leaders say that certain courses, especially acupuncture, hypnosis, or mindfulness, can be acceptable when used for specific indications and when properly framed. They distinguish those from programs in naturopathy, aromatherapy, or homeopathy, which they see as much harder to justify inside medical faculties.
As the Conference of Medical Deans is preparing to examine the issue rigorously, they should – I feel – also consider the ethical implications. Teaching dangerous nonsense to naive students is not just not academic, it is deeply unethical. If done well, this excercise should lead to a major cleanup of universities regarding SCAM, or at the very least to much tighter rules about what can carry an academic label.
Having observed French quackademia for decades, I am tempted to exclaim:
BETTER LATE THAN NEVER!
Homoeopathy and I is the title of a paper that I published in 2009. My aim was to denounce the popular notion that held I had started my research with a grudge against homeopathy. The honest truth is that – if anything – my attitude was even slightly positive. Here is the key section from this 2009 paper:
In 1993, I was appointed to the world’s first Chair in Complementary Medicine, and it became my job to investigate scientifically all sorts of complementary treatments, including homoeopathy. In the course of this activity, my co-workers and I published numerous articles on homoeopathy. Systematically, reviewing the totality of my publication list, I found a total of 46 papers with ‘homeopathy’ in the title. The following quotes from these articles were selected to best describe my attitude toward homoeopathy at the time:
• Homeopathicremedies are believed by doctors and patients to be almost totally safe (8).
• It might be argued that arnica …is ineffective but homeopathy may still works (9).
•…only 23% of Australian homeopaths believe that immunisation is important (10).
• Homeopathy, I fear, has soon to come up with … more convincing evidence (11)…
• Future evaluations of homeopathy should be performed to a high scientific standard (12)…
•…studies on the safety of the practice of homeopathy must not be ignored (13)…
•…systematic reviews based on Medline searches can lead to similar (possibly slightly less positive) overall conclusions (14)…
•…a detailed eye-witness account claiming that all attempts [by researchers during the ‘Third Reich’] to show that homeopathy works has led to negative results (15).
•…the best way forward is clearly to do rigorous research (16)…
• Thus, the question of whether homeopathy works or not has remained unanswered for 200 years (17).
• The most pressing question, ‘Is homeopathy clinically more effective than placebo’, needs to be answered conclusively (18).
• There is evidence that homeopathic treatment can reduce the duration of ileus (19)…
• Some of the well-argued cases against homeopathy should become essential reading for all homeopaths (20).
•…the published evidence to date does not support the hypothesis that homeopathic remedies … are more efficacious than placebo (21)…
•…homeopathic remedies are associated with the same clinical effects as placebo (22).
•…the picture painted by Linde and colleagues … may well be slightly more positive (23)…
•…[our] goal is to conduct rigorous, impartial research in [homeopathy] (24)
• The claim that homeopathic arnica is efficacious beyond a placebo effect is not supported by rigorous clinical trials (25).
• The results of recent systematic reviews are not uniform (26).
•…at present, the relative efficacy of homeopathic remedies is not known (27).
• The results of recent systematic reviews are obviously far from uniform (28).
•…the trial data … do not suggest that homeopathy is effective (29)…
•…the definitive answer, in my view, has to come from a series of rigorous trials (30).
• Large, multicentre trials of homeopathic remedies … represent the best way of advancing the debate (31).
•…the re-analysis of Linde et al. can be seen as the ultimate epidemiological proof that homeopathic remedies are, in fact, placebos (32).
•…randomised clinical trials … do not allow a firm conclusion as to the effectiveness of homeopathic remedies (33).
•…both homeopaths and university heads of medical departments clearly advocate further research into the effectiveness of homeopathy (34).
•…homeopathy is not different from placebo (35).
•…the best clinical evidence … does not warrant positive recommendations (36).
•…the evidence is insufficient for firm recommendations (37).
•…the results of this trial do not suggest that homeopathic arnica has an advantage over placebo (38)…
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- This study provides no evidence that adjunctive homeopathic remedies … are superior to placebo(39).
•…this systematic review does not provide clear evidence that the phenomenon of homeopathic aggravations exists (40).
•…Mathie’s methodology was not as strong as it should have been, and this deficit has led to conclusions that may be falsely positive (41).
•…homeopathy may actually be more expensive than good conventional care (42).
•…the proven benefits of highly dilute homeopathic remedies … do not outweight the potential for harm (43).
•… homeopathic remedies are placebos, but homeopaths can be skilled doctors who may significantly help their patients (44).
• Our analysis … found insufficient evidence to support clinical efficacy of homeopathic therapy (45)…
•… promotion can be regrettably misleading, dangerous and counterproductive (46).
•…do we condone treatments because of their popularity or their effectiveness? (47)
•…homeopathy is not based on solid evidence and, over time, this evidence seems to get more negative (48).
• The evidence from rigorous clinical trials … testing homeopathy for childhood and adolescence ailments is not convincing enough for recommendations in any condition (49).
• There is no evidence at all that homeopathic remedies can change the natural history of any cancer (50).
•…context effects of homeopathy … are entirely sufficient to explain the benefit many patients experience (51)…
• Amongst all the placebos that exist, homeopathy has the potential to be an exceptionally powerful one (52)…
•…recommendations by professional homeopathic associations are not based on the evidence (53)…
[all references can be found in the original paper]
Since then (2009) I – often together with others – have published several further articles with “homeopathy” in the title. This means that my original paper needs updating. Here are the titles of (and links to) these articles (appologies, if I missed a few):
- Should we maintain an open mind about homeopathy?
- Homeopathy
- Homeopathy: what does the “best” evidence tell us?
- Homeopathy, non-specific effects and good medicine.
- A systematic review of homoeopathy for the treatment of fibromyalgia.
- Homeopathy, a “helpful placebo” or an unethical intervention?
- The ethics of British professional homoeopaths.
- Homoeopathy debate. Protecting patients?
- Pharmacists and homeopathic remedies.
- Homeopathy in severe sepsis.
- Call for doctors not to practice homeopathy or refer to homeopaths.
- Homeopathy for eczema: a systematic review of controlled clinical trials.
- The most thorough assessment to date of homeopathy
- Should doctors recommend homeopathy?
If you study these articles, you will find that my arguments around homeopathy remained entirely evidence-based. The overall point is, I hope, clear: I did not embark on my research into homeopathy aiming to disprove it or to dismiss it outright [a claim I still hear with some regularity]. To begin with (in 1993), I was not only open but positively inclined. At all times, however, I was keen to follow the best available evidence. If my attitudes/verdicts became less and less positive, it is merely because the evidence became more and more overtly negative.
Chronic non-specific low back pain (CNSLBP) is a major cause of disability worldwide. Conventional pharmacological treatments offer limited benefits and carry potential risks, prompting interest in alternative approaches, including homeopathy. The objective of this study was to evaluate the short-term efficacy and safety of a standardised homeopathic biotherapic (Lumbar Vertebra, LM2 potency) for CNSLBP.
A randomised, double-blind, crossover, placebo-controlled clinical trial was conducted with 120 participants diagnosed with CNSLBP. Participants received both the biotherapic and placebo in two treatment phases separated by a washout period. The primary outcome was pain intensity (numeric rating scale); secondary outcomes included functional disability (Oswestry Disability Index), adverse events and use of pain medications. Data were analysed using random effects generalised linear models.
Both the biotherapic and placebo interventions led to significant within-group reductions in pain and disability (p = 0.001 and p < 0.001 respectively). However, no statistically significant differences were observed between the two interventions for either outcome (pain: p = 0.435; disability: p = 0.840). The magnitude of change in pain intensity did not reach the pre-defined minimal clinically important difference (MCID), and mean pain scores at the study endpoint remained above the inclusion threshold. Adverse events were mild and comparable across groups.
The authors concluded that no specific effect of the Lumbar Vertebra LM2 biotherapic was demonstrated. Improvements are likely due to non-specific effects such as the therapeutic environment, patient expectations and placebo response. Clinicians should consider the substantial role of non-specific responses in CNSLBP and avoid medications with unfavourable risk–benefit profiles.
One the one hand, the authors from the Department of Medicine, Federal University of São Carlos, São Carlos, Sao Paulo, the School Health Unit, Federal University of São Carlos, São Carlos, Sao Paulo, and the epartment of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil should be congratulated for publishing a squarely negative result in the journal ‘Homeopathy’ that is known for publishing even the most implausible positive findings.
On the other hand, one might criticise them: why on earth did they ever conceive the hypothesis that homeopathy in general or “Lumbar Vertebra LM2 biotherapic” in particular might be effective for CNSLBP (the study did not receive any funding or financial support, apart from the study medications donated by HN-Cristiano Pharmacy (Santana, São Paulo, Brazil), which had no role in the study design, data collection, analysis, interpretation or discussion of the results)? I have never met a homeopaths who would make such a claim, and one could easily argue that such a trial is an unethical waste of resources.
The defence of anthroposophical medicine – or of any other unproven modality – as articulated, for example, by figures like Weleda CEO Tina Müller, presents a vision of patient-centred care and economic pragmatism. However, when held against the light of current clinical standards and the principles of evidence-based medicine (EBM), it reveals significant cracks.
The most profound problem lies in the definition of scientific evidence. Proponents often point to decades of “positive experience” and high patient satisfaction as proof of effectiveness. Yet, in the hierarchy of science, anecdotal success sits at the very bottom. Anthroposophical treatments lack biological plausibility. Their perceived benefits are largely indistinguishable from context effects (such as placebo). Anthroposophical medicine might provide more time, empathy, and personal attention – factors that undoubtedly improve a patient’s well-being but do not validate the effectiveness of the specific remedies used. When independent bodies subject these treatments to rigorous, high-quality trials, the purported effects usually vanishe.
Anthroposophical medicine represents merely a tiny percentage of our healthcare expenditures. Therefore, proponents argue, little money would be saved by getting rid of it. This argument is a calculated distraction from the ethical core of the issue. While the fiscal burden may be marginal, the scientific cost is immense. A statutory health insurance system is built on a social contract of solidarity; it functions under the premise that public funds are reserved for treatments of proven value and effectiveness. To fund therapies that lack plausibility as well as reproducible results is to erode the credibility of medicine and rational thought. It is not a question of the amount of money, but the principle of integrity: every Euro, £ and $ spent on unproven treatments is a euro, £, and $ diverted from underfunded and often life-saving healthcare.
The regularly made appeal to the Swiss Model as a beacon of success also requires a more critical reading. The integration of so-called alternative medicine (SCAM) in Switzerland was, at its heart, a result of direct democracy rather than evidence. While the Swiss public voted for inclusion, the majority of the medical community remains deeply sceptical. To cite Switzerland as “proof” that anthroposophical medicine has fulfilled the criteria of EBM is to conflate political popularity with scientific validation. Democracy can decide how a nation spends its money, but it cannot vote a reliable evidence-base into existence.
Finally, we must consider the human risk of legitimizing non-evidenced-based practices. When a state-sanctioned insurance system places such therapies on the same pedestal as EBM, it risks misleading vulnerable individuals. For patients facing chronic or life-threatening illnesses, the “integrative” path can lead to a dangerous delay in seeking conventional, life-saving interventions. By treating subjective belief and peer-reviewed science as equal peers, we risk entering a “post-truth” medical era where the desire for a “natural” or “holistic” experience outweighs the necessity for proof.
In conclusion, while the call for a more “human” and “holistic” medical system might be noble, it must not come at the expense of scientific rigor. It is deeply misleading to imply that this is an ‘either or’; good medicine will always be based on both. A healthcare system that prioritizes popularity over proof risks becoming a system of expensive comfort rather than one of effective healing. True patient appreciation lies not in offering unproven choices, but in ensuring that every treatment covered by the public purse is supported by sound evidence. Not following this strategy is a disservice to patients and to progress.
So, the next time you hear people defending anthroposophical medicine or any other unproven modality, please look behind the smoke screen and find out why they do it. More often than not, you will then identify a massive conflict of interest. My advice is to listen to independent experts and to dismiss the people with an axe to grind.
The Spanish Agency for Medicines and Medical Products (AEMPS) has just published a comprehensive technical report entitled “Homeopathy and Homeopathic Products: Evaluation of Evidence on Their Efficacy and Safety”, which categorically concludes that there is no scientific evidence supporting the efficacy of homeopathy as a therapeutic tool. After a systematic review of scientific literature and evaluations by state agencies internationally, the report states that the observed effects are comparable to placebo.
The report, which analyzed 64 systematic reviews published since 2009, highlights that most studies suggesting benefits from homeopathy have low methodological quality, often invalidated by small samples, short follow-up periods, or biases in randomization. Furthermore, it notes that as the quality and rigor of clinical trials increase, the supposed effect of homeopathy diminishes until it disappears entirely.
From a scientific standpoint, the principles of homeopathy clash with the laws of physics and current pharmacology. In typical dilutions like 12 CH—where one part of the original substance is mixed with 100 parts of solvent twelve times consecutively—it is mathematically impossible for a single molecule of the original ingredient to remain in the preparation, breaking any cause-and-effect relationship between the product and the therapeutic effect.
To illustrate this disproportion, the report points out that a dilution of just 6 CH (far less extreme than 12 CH) equates to dissolving a packet of sugar in the entire Mediterranean Sea. For this reason, the AEMPS classifies theories like “water memory”—the belief that the liquid retains the properties of a substance even without its molecules—as empirically baseless postulates that challenge scientific and rational thinking.
In compliance with European and national regulations, the AEMPS has completed a regularization process that has resulted in the market withdrawal of numerous products. As of the report’s publication date, no homeopathic product with authorized therapeutic indications exists in Spain. The 976 that remain registered did so via a simplified procedure, based on extreme dilutions ensuring the preparation’s innocuousness, which does not require proof of therapeutic effect and legally prohibits any therapeutic claims on labeling.
Spain aligns with a global trend of health institutions adopting critical stances:
- United Kingdom: The Science and Technology Committee recommended halting public funding and requiring labeling warnings about lack of efficacy.
- Australia: The National Health and Medical Research Council concluded that homeopathy should not be used for chronic or serious diseases.
- France: The Haute Autorité de Santé eliminated public reimbursement for these products in 2021 due to lack of demonstrated efficacy.
- Germany: Approval is expected in 2026 for the definitive removal of homeopathy coverage from statutory health insurance.
- United States: The Food and Drug Administration (FDA) considers these products “unapproved new drugs,” and the Federal Trade Commission requires warnings that there is no scientific evidence of their functioning.
Although there is a popular belief that these preparations are innocuous because they are “natural,” serious adverse reactions have been reported, including poisonings from poor dosing and infant deaths linked to teething products in other countries.
However, the AEMPS warns that the main associated risk is the abandonment or delay of proven effective medical treatments. Citizens opting for homeopathy to treat serious or chronic conditions may endanger their health by replacing evidence-based therapies with products lacking such evidence.
The AEMPS report reaffirms the Ministry’s commitment to public health protection and evidence-based medicine. In line with other international agencies, it emphasizes the need for transparent information so citizens can make safe health decisions. The conclusion of the report is firm:
Given the lack of evidence of efficacy, homeopathy cannot be considered a valid therapeutic alternative, and its use must not lead to delaying or abandoning treatments proven to be effective.
Pediatric vertebral artery dissection (VAD) following chiropractic cervical manipulation (CCM) is a rare phenomenon. As chiropractic care of pediatric populations increases internationally, it is imperative to increase awareness of this cause of VAD.
This case-report describes a patient encountered in the Department of Neurological Surgery, Indiana University School of Medicine, USA. He was a 20-month-old male who presented nonspecifically with acute onset of
- lethargy,
- vomiting,
- cyanosis,
- respiratory distress.
Cerebrovascular imaging revealed a luminal irregularity in the V4 segment of the right vertebral artery, consistent with dissection. The patient’s guardian later provided history of taking the child for cervical chiropractic corrections immediately prior to the patient’s presentation to the emergency department.
The patient was managed non-operatively. Intubation was performed due to respiratory distress and managed with fluids, vasopressors, antimicrobials, and high-flow oxygen. The patient was extubated four days after presentation, and pressors were discontinued upon achievement of hemodynamic stability. A few days after extubation, the patient was ambulating and able to interact with objects and caretakers. Aspirin therapy was initiated and continued after discharge. The patient was followed with annual appointments and imaging. At two-year follow-up, CTA demonstrated an asymmetrically small right vertebral artery, accompanied by encephalomalacia of the right posterior occipital lobe. MRA demonstrated diffuse narrowing of the V4 segment of the right vertebral artery, albeit less pronounced than prior MRAs. Aspirin was discontinued by an outside following team due to stability of imaging findings. The parents were advised to avoid contact sports to avoid trauma and recurrent stroke.
The authors found 2 further cases of pediatric VAD in the published literature following CCM. Non-specific presentations were noted in both of them. Appropriate diagnosis of pediatric VAD requires increased surveillance in response to a thorough history and an acknowledgment of the plethora of possible patient presentations and etiologies.
The authors concluded that there is an increasing utilization of chiropractors among the pediatric population. In a pediatric patient with nonspecific symptoms, VAD should be considered as a differential diagnosis when there is a history of CCM.
The authors’ statement that “pediatric vertebral artery dissection (VAD) following chiropractic cervical manipulation (CCM) is a rare phenomenon” should be taken with a pinch of salt. As there is no monitoring, the frequency of adverse effects and complications is essentially unknown. Crucially. the risks of CCM for children is by no means confined to VADs. For a fuller account, I recomment reading my book which has an entire chapter on this very subject.
The key messages about CCM for kids might be summarised in the following simple three facts:
- CCM has no true benefit for children.
- Thus the risk/benefit balance fails to be positive.
- Therefore we should discourage partents from taking their kids to see chiropractors.
We all know, I think, what homeopaths say about homeopathy. We also know what everyone else says about it. And the two set of opinions could not be more different. In this context, it might be interesting to learn what writers have to say about the subject. Here is a list of quotes from the non-medical, non-scientific literature (I am sure there are many more; if you know some, please let me know):
Boyd, W. (Restless, 2006)
“She had a small leather case of homeopathy remedies, Nux Vomica, Pulsatilla, Arnica, that she treated like a traveling reliquary.”
Coetzee, J.M. (Elizabeth Costello, 2003)
“He is a believer in homeopathy, in the healing power of water, in the memory of water. He is a man of the eighteenth century, really.”
Cunningham, M. (The Hours, 1998)
“She has tried everything: homeopathy, psychotherapy, prayer. She is a woman who lives in the hope of a miraculous adjustment.”
Enright, A. (The Gathering, 2007)
“My mother had a great belief in homeopathy, which is just a way of saying she had a great belief in nothing at all, provided it came in a very small bottle.”
Franzen, J. (The Corrections, 2001)
“Enid was deep into a phase of homeopathy, convinced that a decillionth of a gram of honeybee sting would cure her husband’s tremors.”
Márquez G.G. (“Serenade: How My Father Won My Mother”, 2001)
“…devoted his talent as an autodidact to a science on the decline: homeopathy.”
Hustvedt, S. (The Blazing World, 2014)
“He was the kind of man who treated his neuroses with homeopathy and his physical ailments with intense, silent resentment.”
McEwan, I. (Solar, 2010)
“He had no time for homeopathy, which he considered a form of witchcraft for people who were too polite to carry crystal wands.”
O’Farrell, M. (Instructions for a Heatwave, 2013)
“She kept a kit of homeopathy in her bag, tiny glass vials of white pills that looked like the breath of ghosts.”
Self, W. (How the Dead Live, 2000)
“Lily’s faith in homeopathy was such that she believed if she diluted her own death enough, she might eventually become immortal.”
St. Aubyn, E. (At Last, 2011)
“He had reached that stage of desperation where even homeopathy seemed like a robust and evidence-based option.”
H.G. Wells (Tono-Bungay, 1909)
“By the time my uncle had taken to homeopathy, I realized that his faith in science was of a very elastic kind.”
George Bernard Shaw (Preface to The Doctor’s Dilemma, 1906)
“I have a faith in homeopathy that would make a Harley Street physician shudder, though I suspect it rests less on evidence than on temperament.”
Thomas Mann (The Magic Mountain, 1924)
“He spoke of homeopathy with a curious mixture of irony and conviction, as though the less there was of it, the more there must be.”
Aldous Huxley (Eyeless in Gaza, 1936)
“She placed her trust in homeopathy, preferring infinitesimal certainties to the gross invasions of modern medicine.”
Doris Lessing (The Golden Notebook, 1962)
“She was experimenting with diets and homeopathy, as if the body might be coaxed into sanity by gentler means.”
Margaret Atwood (Cat’s Eye, 1988)
“My mother believed in homeopathy, in small doses and invisible forces, which seemed to me another way of saying she believed in hope.”
Zadie Smith (White Teeth, 2000)
“He dabbled in homeopathy, convinced that the less substance there was, the more profound the cure.”
David Lodge (Therapy, 1995)
“I tried homeopathy for a while, but it seemed to require a belief in something so small it might not exist at all.”
Hilary Mantel (Giving Up the Ghost, 2003)
“Homeopathy offered the promise of healing without intrusion, a whisper of cure rather than a command.”
Martin Amis (The Information, 1995)
“He regarded homeopathy as a joke that had somehow outlived the punchline.”
______________________
It seems to me that, when it comes to homeopathy, the writers tend to agree with the scientists.
I recently came across an aricle entitled “Reiki for Stress Relief” which I thought was excptional even for the often surprising literature on Reiki. Here is the abstract:
Reiki is Holistic. It isn’t just about the mental, or just about the physical, but both, and an overall restoration and improvement to you. And as we know, often the mental and physical are linked.
While the scientific understanding of Reiki’s effects on emotional blocks is still evolving, many individuals report subjective benefits, such as emotional release, relaxation, and a greater sense of inner peace, following Reiki sessions.
As the philosophy of Reiki is grounded in holistic medicine and thought, it is imperative to continue that tradition and also integrate other scientific -backed therapies such as the ones your doctor may suggest if you have a serious medical or mental condition. A balanced approach is key, and Reiki is possibly a powerful tool and philosophy that can be the missing key or complement to your current care regimen.
This is impressive! Don’t you just love how it’s ‘grounded in holistic thought’ while the scientific understanding is ‘still evolving’ ? That’s a very elegant way of admitting ‘we’re still waiting for the first piece of evidence’. And we all appreciate the disclaimer to actually see a real doctor as soon as we are truly ill.
The Canadian comedian Mayce Galoni had perhaps the best measure of Reiki when he did his stand-up bit about his nephew “becoming a Reiki master” at the age of 21: “My 21-year-old nephew is now a Reiki master. I didn’t even know you could be a master of anything at 21… Reiki is the only career where you can get paid for doing exactly what I do when I can’t find the TV remote.”
Sufficient evidence concerning the impact of traditional Chinese medicine (TCM) on clinical outcomes for breast cancer patients in Taiwan is not available. This study sought to examine the association between TCM integration and post-operative outcomes among women undergoing mastectomies.
Utilizing a large insurance database, the Taiwanese researchers identified a cohort of adult women who underwent breast cancer surgery during the 2010–2019 period. They compared sociodemographic profiles and comorbidities between TCM users and non-users. Multiple logistic regression models were employed to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for both mortality and postoperative complications.
Among 91,298 eligible patients, the one-year pre-operative prevalence of TCM utilization was 40%. Compared to the control group, TCM users demonstrated:
- a significantly lower likelihood of postoperative stroke (OR 0.76, 95% CI 0.62–0.93),
- and a reduced requirement for intensive care (OR 0.74, 95% CI 0.59–0.91).
Moreover, the cumulative exposure of more than 4 TCM consultations within the year preceding surgery was linked to a decreased risk of stroke (OR 0.76, 95% CI 0.61–0.95).
The authors concluded that “our findings indicate that integrating TCM during the year preceding breast cancer surgery is correlated with lower risks of postoperative stroke and a reduced requirement for intensive care. Nevertheless, these observed benefits warrant further verification through prospective and large-scale clinical investigations. Based on these results, we suggest that both Western medical practitioners and public health administrators should be mindful of TCM’s role in the comprehensive care of patients with breast cancer.”
In the paper itelf, the authors “hypothesize that pre-operative TCM integration contributes to the observed reduction in stroke risk and intensive care requirements following mastectomy. These prior insights provide a plausible biological foundation for the favorable outcomes observed in our study”. In other words, they believe that the associations is causal.
I beg to differ!
Much research has demonstrated that people who use so-called alternative medicine (SCAM) in addition to conventional therapies differ from those who don’t. In general, they tend to be more health concious – if not, they would not go to the trouble of using and paying for SCAM. This difference alone suffices to bring about the observed outcomes – even if TCM has no or perhaps a slightly negative overall health effect.
But let’s be generous!
Let’s assume the authors are correct in assuming that the association is causal and that TCM brought about the observed outcomes.
What does that actually mean?
TCM consists of many different modalities. If we just focus on oral medications and assume that there are 1000 different ones [in fact, the number is about 6 times higher], which one do we take to experience the observed outcome? Perhaps all of them?
What I am trying to point out that such research is meaningless; it has zero practical consequences, even if its results were real – which they probably are not.
In the end, it boils down to one main thing: the promotion of unproven (and occasionally dangerous) TCM.
Although currently the COVID-19 pandemic is no longer a public health challenge, the unprecedented utilization and integration of Ayush therapeutics and principles for the COVID-19 response in India represent a critical health systems and policy experiment which needs a systematic evaluation.
A systematic review and meta-analysis was conducted, and the data were extracted till 9th July 2024 using three databases: Scopus, PubMed and DOAJ. A total of seven articles were included for the review, following the PICOS criteria of inclusion and exclusion. Of the 667 articles, seven articles were finally selected, and these articles underwent quality assessment using the AXIS assessment tool. The pooled proportion of the Indian population that utilized the Ayush systems was estimated at a 95% confidence interval, using a random effects model assuming potential heterogeneity. The pooled estimate, publication bias, heterogeneity and sensitivity analysis were graphically represented using a forest, funnel, Galbraith plots and leave-one-out meta-analysis. Additionally, the effects of the small studies were assessed using Egger’s and Begg’s tests. The total sample across the included studies was 789,735. Of the seven articles, six focused on the general population, and five focused on the utilization of the Ayurveda system of medicine. The pooled proportion of the Indian population that utilized the Ayush systems for COVID-19 was 40% (95% CI: 25% − 57%). Based on the policy relevance, risk of exposure, access to guidelines and pattern of utilization two subgroup analyses were carried out. Utilization of multiple systems of Ayush (48%) and utilization among the general population (46%) showed the highest proportion compared to Ayurveda and healthcare workers, respectively. The high heterogeneity (I2 = 99.98%) suggests that the pooled estimate should be interpreted with caution, and the sensitivity analysis found one study had a modest upward influence on the overall estimate.
The authors concluded that this systematic review found a 40% pooled estimate of utilization of Ayush systems from the included studies, suggesting the utilization of these systems to manage mild and asymptomatic conditions and for preventive purposes.
This review reports a 40% pooled utilization rate of Ayush systems for COVID-19 in India, based on just seven studies with a massive sample but extreme heterogeneity (I²=99.98%). Such high heterogeneity undermines the reliability of the pooled estimate, as noted in the study’s own caution and sensitivity analysis showing one study’s outsized influence.
Only seven articles met PICOS criteria from 667 screened, mostly surveys on self-reported use among general populations, without assessing clinical efficacy or outcomes. Quality via AXIS tool is mentioned, but broader Ayush COVID evidence reveals high risk of bias in many trials due to poor randomization, blinding, and variability in interventions. No causal link is drawn between Ayush use and health impacts; the paper merely quantifies popularity amid government promotion.
India faced ~2.4-4.7 million excess deaths in 2020-2021, 7-10x official COVID figures, driven by Delta wave surges, oxygen shortages, and healthcare collapse. Widespread Ayush integration for prevention and mild cases – endorsed by Ministry of Ayush! – did not correlate with better results; high utilization (40-48% in subgroups) coincided with catastrophic mortality levels. Sound evidence for Ayush benefits does not exist. One might therefore speculate that the promotion of Ayush may have diverted resources from proven measures like vaccination and antivirals. In other words, it seems likely that it cost many lives.
