As The Complementary Medicine Debate Continues, Patients Lose

In an editorial published in BMJ Clinical Evidence,
complementary medicine (CM) expert Professor Edzard Ernst writes that
patients are continuously and seriously being misled by the debate over
complementary medicine's efficacy. Ernst believes that arguments, as
presented by two different and somewhat hostile attitudes that
influence evidence about the practice, leave unanswerable the
fundamental question concerning complementary medicine - Does
it generate more harm than good?



Complementary medicine includes several practices, the most popular of
which are acupuncture, homeopathy, spinal manipulation, and herbal
medicine. One side of the debate argues that there is no scientific
evidence that can support CM, while the other side believes that
scientific evidence cannot be applied to CM.



Ernst writes that skeptics of complementary medicine are particularly
good at ignoring evidence that is related to the field. Of the extant
thousands of clinical trials and hundreds of systematic
reviews, it is not common to see mainstream journals publishing
positive findings, which lead many to believe that there is not much
serious research investigating complementary medicine or that the
practice is harmful or useless.



On the other side of the debate is the camp that supports complementary
medicine. When researchers come to conclusions that are not in line
with their beliefs, these proponents are quick to point out that there
is no place for scientific evidence in complementary medicine.



"The loser in these everlasting quibbles and debates is, of course, the
patient," writes Ernst. "If they listen to the 'there is no evidence'
argument, they might not benefit from those forms of CM that are
beneficial. If they follow the 'science does not apply' notion, they
might end up receiving treatments that generate more harm than good."



It is apparent to Ernst that it is the "almost insatiable
hunger
of patients" for complementary medicine that has driven the
importance of CM, not the eagerness of doctors, the interests of
scientists, or the
attention of politicians. In addition, because CM is usually
unavailable through the National Health Service, patients are spending
??1.6 billion in Britain every year to purchase complementary medicine
products - and the effects of these are often uncertain.



Ernst concludes that, "Change is necessary, and positive change is best
achieved if we begin to produce reliable information specifically for
lay people."



Complementary medicine and evidence: like fire and water?

Edzard Ernst

BMJ. (April 2008)

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Written by: Peter M Crosta