What alternative health

practitioners might not tell you



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“We have all heard of the ‘hierarchy of evidence’. It describes a hierarchy of study designs for testing the effectiveness of therapeutic interventions and enables us to contemplate the relative merits of different types of investigations. In my field, complementary medicine, the logic behind this hierarchy has remained a hotly disputed topic. Many believers in complementary medicine seem to reject it and some even seem to have started promoting something I call the ‘anarchy of evidence’. Enthusiasts of this or that complementary therapy invariably seem to be in favour of evidence-based medicine — but only as long as its application to their subject generates the results they had hoped for! Whenever the evidence fails to show that their therapy is effective, they call for a different standard. The reason is simple: enthusiasts are led by belief rather than evidence: if a rigorous randomised clinical trial does not demonstrate that their therapy is effective, it usually is not the treatment but the test that is deemed to be at fault. The thought that their belief was wrong is unthinkable to believers.” Edzard Ernst, British Journal of General Practice (February 2010)