PERSONAL VIEW
Cause and effect relationships
The "dirty tricks" experience can play on us
Correspondence to:
Correspondence to:
Prof Edzard Ernst
Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, 25 Victoria Park Road, Exeter EX2 4NT, UK; Edzard.Ernst@pms.ac.uk
The therapeutic effect of a medical intervention can be due to the specific effects of a therapy. In addition, there is a multitude of other determinants. The totality of their impact can be such that even a treatment causing no or negative specific effects can be followed by positive perceived therapeutic response.
| The first 150 words of the full text of this article appear below. |
"At least treatment x does not harm my patient." How often do clinicians think along these lines? In my field of complementary/alternative medicine, it is arguably the most common reason for using this or that therapy: there is usually little "hard" evidence to suggest harm (by "harm" I mean a negative effect on the disease, not a simple adverse effect). So, if treatment x does not make the condition worse and the patient is keen to try it, we may well decide to condone its use. There is nothing wrong with such a decision—or is there?
If reliable data are missing, how do we know treatment x does not worsen the condition? For one, we have our experience. Then there is the fact that this treatment may have been around for decades or even centuries. And perhaps a few observational studies are also available—of course, this
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This article has been cited by other articles:
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Ernst, E.
(2008). How the public is being misled about complementary/alternative medicine. JRSM
101: 528-530
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