Scientific evidence was ignored in CAM and the NHS

doi:10.1136/bmj.331.7523.1024-b

BMJ 2005;331:1024 (29 October), doi:10.1136/bmj.331.7523.1024-b

Letter

Scientific evidence was ignored in CAM and the NHS

The first 150 words of the full text of this article appear below.

EDITOR—We would like to correct an error in Thompson andFeder's description of the methodology of our systematic reviewof UK cost effectiveness studies of complementary and alternativemedicine (CAM).^1
2 We did not search for randomised studies.We included all prospective, controlled studies of any CAM modalitycarried out in the UK. All five happened to be randomised.

That there were only five such studies restricted to spinalmanipulation (four studies) and acupuncture (one) and that onlythree of them make useful comparisons with usual care, underlinesthe paucity of such data in the UK. A further study on acupuncturefor back pain has a similar result: a small effect size of questionableclinical significance in a trial design without patient blindingor sham control and a favourable estimate of cost per qualityadjusted life year (QALY).³ Such studies may simply be estimatingthe cost effectiveness of placebo . . . [Full text of this article]

Peter H Canter, research fellow

peter.canter@pms.ac.uk
Complementary Medicine, Peninsula Medical School, Exeter EX2 4NT

Edzard Ernst, director

Complementary Medicine, Peninsula Medical School, Exeter EX2 4NT

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