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July 2004, Vol 94, No. 7 | American Journal of Public Health 1074
© 2004 American Public Health Association

LETTER

THE NEED FOR SCIENTIFIC RIGOR IN STUDIES OF COMPLEMENTARY AND ALTERNATIVE MEDICINE

Edzard Ernst, MD, PhD, FRCP, FRCPEd

Correspondence: Requests for reprints should be sent to Edzard Ernst, MD, PhD, FRCP, FRCP(Ed), Complementary Medicine, Peninsula Medical School, 25 Victoria Park Rd, Exeter, Devon EX2 4NT, United Kingdom (e-mail: edzard.ernst{at}pms.ac.uk).

Weze et al. submitted 76 patients with musculoskeletal pain to 4 sessions of spiritual healing. A before–after comparison of questionnaire data provided "strong circumstantial evidence of benefit."1(p51) I would challenge this conclusion on at least 2 grounds. First, the placebo response alone could fully explain the result. We have shown in a randomized clinical trial that pain sufferers’ response to sham healing is indistinguishable from their response to "real" healing of a similar type.2 Second, the possibility exists that patients completed the questionnaires overoptimistically to please the team of investigators and researchers simply because they were kind and empathetic. My main point is that clinical trials, particularly those in controversial areas such as healing,3 should be conducted according to accepted standards of scientific rigor. Uncontrolled studies using questionnaires or other soft endpoints are prone to create more confusion than knowledge.

References

1. Weze C, Leathard HL, Stevens G. Evaluation of healing by gentle touch for the treatment of musculoskeletal disorders. Am J Public Health. 2004;94:50–52.[Free Full Text]

2. Abbot NC, Harkness EF, Stevinson C, Marshal FP, Conn DA, Ernst E. Spiritual healing as a therapy for chronic pain: a randomized, clinical trial. Pain. 2001;9:79–89.

3. Astin JA, Harkness EF, Ernst E. The efficacy of "distant healing": a systematic review of randomized trials. Ann Intern Med. 2000;132:903–910.[Abstract/Free Full Text]




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Arch Intern Med, September 26, 2005; 165(17): 2026 - 2031.
[Abstract] [Full Text] [PDF]

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