Experts denounce clinical trials of unscientific, 'alternative' medicines

August 20, 2014

Experts writing in the Cell Press journal Trends in Molecular Medicine on August 20th call for an end to clinical trials of "highly implausible treatments" such as homeopathy and reiki. Over the last two decades, such complementary and alternative medicine (CAM) treatments have been embraced in medical academia despite budget constraints and the fact that they rest on dubious science, they say.

The writers, David Gorski of Wayne State University School of Medicine and Steven Novella of Yale University, argue that, in these cases, the medical establishment is essentially testing whether magic works. Gorski and Novella are both editors for Science-Based Medicine, an organization and blog dedicated to exploring the complicated relationship between science and medicine.

"We hope this will be the first of many opportunities to discuss in the peer-reviewed literature the perils and pitfalls of doing clinical trials on treatment modalities that have already been refuted by basic science," said Gorski. "The two key examples in the article, homeopathy and reiki, are about as close to impossible from basic science considerations alone as you can imagine. Homeopathy involves diluting substances away to nothing and beyond, while reiki is in essence faith healing that substitutes Eastern mysticism for Christian beliefs, as can be demonstrated by substituting the word 'god' for the 'universal source' that reiki masters claim to be able to tap into to channel their 'healing energy' into patients."

"Studying highly implausible treatments is a losing proposition," Novella added. "Such studies are unlikely to demonstrate benefit, and proponents are unlikely to stop using the treatment when the study is negative. Such research only serves to lend legitimacy to otherwise dubious practices."

What is needed, say Gorski and Novella, is science-based medicine rather than evidence-based medicine. Biologically plausible treatments should advance to only when there is sufficient preclinical evidence to justify the effort, time, and expense, as well as the use of human subjects.

"Somehow this idea has sprung up that to be a 'holistic' doctor you have to embrace pseudoscience like homeopathy, reiki, traditional Chinese medicine, and the like, but that's a false dichotomy," Gorski said. "If the medical system is currently too impersonal and patients are rushed through office visits because a doctor has to see more and more patients to cover his salary and expenses, then the answer is to find a way to fix those problems, not to embrace quackery. 'Integrating' pseudoscience with science-based medicine isn't going to make science-based medicine better. One of our bloggers, Mark Crislip, has a fantastic saying for this: 'If you mix cow pie with , it does not make the cow pie taste better; it makes the apple pie worse.' With CAM or 'integrative ,' that's exactly what we're doing, and these of magic are just more examples of it."

Gorski and Novella call on patients to exercise their critical thinking skills when it comes to evaluating the evidence for or against any kind of treatment, whether it is deemed "alternative" or not. "Critical thinking will help patients learn to recognize when a course of treatment is not supported by data or to tell when a health claim from any practitioner is just too good to be true," Gorski said.

Explore further: US states move to expand experimental drug use (Update)

More information: Trends in Molecular Medicine, Gorski et al.: "Clinical trials of "integrative" medicine: Testing whether magic works?."

Related Stories

US states move to expand experimental drug use (Update)

May 17, 2014
Nick Auden didn't live to see the legislation, but the case of the Colorado melanoma patient who died while seeking access to an experimental drug helped inspire a first-of-its kind law.

Providing futile care in the ICU prevents other patients from receiving critical care

August 20, 2014
Providing futile treatment in the intensive care unit sets off a chain reaction that causes other ill patients needing medical attention to wait for critical care beds, according to a study by researchers from UCLA and RAND ...

Women under-represented in academic medicine

July 10, 2014
Women are under-represented in academic medicine resulting in a waste of public investment due to loss of research talent. Writing in the July issue of the Journal of the Royal Society of Medicine, authors of an essay on ...

Improve peer review by making the reviewers better suited to the task

July 30, 2014
A 'kitemark' that identifies randomized-controlled trials reviewed by specially trained peer reviewers would improve public trust in the robustness of clinical trials, according to an opinion piece in the open access journal ...

Recommended for you

Female researchers pay more attention to sex and gender in medicine

November 7, 2017
When women participate in a medical research paper, that research is more likely to take into account the differences between the way men and women react to diseases and treatments, according to a new study by Stanford researchers.

Drug therapy from lethal bacteria could reduce kidney transplant rejection

August 3, 2017
An experimental treatment derived from a potentially deadly microorganism may provide lifesaving help for kidney transplant patients, according to an international study led by investigators at Cedars-Sinai.

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

Team eradicates hepatitis C in 10 patients following lifesaving transplants from infected donors

April 30, 2017
Ten patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease. The findings point to new strategies for increasing ...

'bench to bedside to bench': Scientists call for closer basic-clinical collaborations

March 24, 2017
In the era of genome sequencing, it's time to update the old "bench-to-bedside" shorthand for how basic research discoveries inform clinical practice, researchers from The Jackson Laboratory (JAX), National Human Genome Research ...

The ethics of tracking athletes' biometric data

January 18, 2017
(Medical Xpress)—Whether it is a FitBit or a heart rate monitor, biometric technologies have become household devices. Professional sports leagues use some of the most technologically advanced biodata tracking systems to ...

8 comments

Adjust slider to filter visible comments by rank

Display comments: newest first

Jim4321
1 / 5 (2) Aug 20, 2014
The authors say that faith based healing is pseudoscience. Do they then believe that the placebo effect is non existent? If the placebo effect is real then it seems that it must follow that that social and religious interventions aimed at the patient's psyche may provide healing . So, Placebo -- yes or no!
Vietvet
5 / 5 (2) Aug 20, 2014
The placebo effect might work for some individuals in some cases, pain relief for example. But try curing lung cancer with a placebo.
Jim4321
not rated yet Aug 20, 2014
Point taken vietvet. However, there has to be a reason why all "gold standard" clinical trials are compared to placebo. Obviously, the placebo effect extends beyond pain management or it wouldn't be the standard of comparison for all new drugs. I believe that the extent of placebo effectiveness is not yet known. Thank you for your service.
ReallyGoodMedicine
1 / 5 (4) Aug 20, 2014
These are the facts about homeopathy: There are 600 basic science studies, clinical trials and observational studies that show homeopathy produces biological effects and significant to substantial health benefits in a wide array of conditions. They are published in 124 respected, nat'l and internat'l peer reviewed journals. Some of them can be seen at the web site of the Nat'l Ctr for Homeopathy. Homeopathy is famous for its cures of chronic diseases, diseases often considered incurable by conventional medicine. Googling "homeopathy cured cases" brings up hundreds of case records of cures of conditions from cancer to psychogenic diabetes mellitus to addiction to Rx drugs to gangrene. The cured cases of lung cancer, brain tumors, osteosarcoma and cancer of the oesophagus found at the web site of Prasanta Banerji Homeopathy Research Foundation are documented with CT scans, x-rays, histopathological reports and blood work.

Roj
1 / 5 (2) Aug 20, 2014
If the same double blind, controlled for placebo, clinical trial used to approve pharmaceuticals, are indeed legitimate tests for efficacy, why is that illegitimate for non-pharmaceuticals.

Unless the authors can share why clinical trials may be unreliable or corrupt, then lobbying to halt the application of these scientific standards, or halt funding for clinical trials is highly suspect.

We are left to consider a conflict of interest, if David Gorski of Wayne State University School of Medicine and Steven Novella of Yale University, are funded by pharmaceutical companies.
ReallyGoodMedicine
1 / 5 (2) Aug 21, 2014
If the same double blind, controlled for placebo, clinical trial used to approve pharmaceuticals, are indeed legitimate tests for efficacy, why is that illegitimate for non-pharmaceuticals.

Unless the authors can share why clinical trials may be unreliable or corrupt, then lobbying to halt the application of these scientific standards, or halt funding for clinical trials is highly suspect.

We are left to consider a conflict of interest, if David Gorski of Wayne State University School of Medicine and Steven Novella of Yale University, are funded by pharmaceutical companies.


Gorski (aka Orac/Respectful Insolence/ScienceBasedMedicine) has undisclosed financial ties to the vaccine industry through Wayne State. Gorski and Novella work together on the ScienceBasedMedicine site.

Check out The Bolen Report and Age of Autism web site.
Nik_2213
5 / 5 (1) Aug 23, 2014
As I said to a former friend who believes in homeopathy (etc), if the more dilute the better, why take the stuff at all ? Surely just looking at that expensive stuff through the shop window would suffice ?

(Let's not forget her meditation pyramid which was supposed to block 'Unhealthy EMF' from radio transmitters etc. The openings were too big by a factor of ~10^3 to play 'Faraday Cage'. At least the frame was copper... ;-)
kochevnik
not rated yet Aug 24, 2014
Many big-pharma drugs were stolen or copied from alternative medicine. These corporate shills simply want to kill of the competition now that they've stolen everything of value from the natives

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.