Commissioning complementary medicine

BMJ 1995;311:809 (23 September)

Letters

Commissioning complementary medicine

Evaluations of efficacy of treatments should be consistent

EDITOR,--In his editorial Iain Smith calls for research to obtainevidence of the efficacy of complementary procedures, and weagree that "the burden of proof should be no greater, or less,than for mainstream medicine."¹ In the next paragraph, however,he says that randomised controlled trials "may fail to allowfor the holistic effect that is central to the philosophy ofmost complementary therapies" and that "the beneficial effectsare often so obvious, the side effects so rare and mild, andthe duration of effect so variable after even a single exposurethat perhaps observational studies may be enough to prove benefit."He then cites Black, who quotes defibrillation for ventricularfibrillation as an example of a treatment with an impact solarge that observational data are sufficient to show it.²