Research Into Complementary/Alternative Medicine: A Personal Comment

Abstract

1. The amount of wrong or misleading information on CAM, for example, on the Internet, in popular books, newspaper articles, and so on, is colossal and by far exceeds that in neurology, gynaecology, rheumatology, or any other medical field. The following three misconceptions are, in our experience, the most widespread: (a) Proponents often claim that CAM somehow defies scientific evaluation. Yet they are more than willing to refer to scientific tests of CAM—as long as the results are positive (e.g., Mathie, 2003). (b) Enthusiasts of CAM frequently contend that the treatments are risk-free. However, important direct and indirect risks have been identified for virtually all CAM modalities (Ernst, Pittler, Wider, & Boddy, 2006). (c) Both opponents and proponents of CAM, for different reasons, often maintain that there is no or very little scientific evidence in CAM or sections of CAM. Yet, on closer inspection, one finds at least some preliminary evidence in almost all areas of CAM (Ernst et al., 2006). 2. The clinical practice of CAM is remarkably resistant to scientific evidence. Most practitioners continue to insist that their intuition and experience are more reliable than the results of rigorous clinical trials. They are thus unwilling to abandon their treatments if the best available evidence shows they have no specific effects or might even be harmful. It is my impression that, for some practitioners and for many patients, CAM is more akin to a religion than to a form of healthcare. To them, belief counts more than facts. 3. Despite these obstacles, research into CAM has made considerable progress. I estimate that approximately 5,000 clinical trials of CAM have been published during the last decade. Their quality and results are, of course, mixed. Based on these data, it is possible to classify CAM into three categories (Ernst et al., 2006).