BMJ  2005;331:1205 (19 November), doi:10.1136/bmj.331.7526.1205

Letter

CAM before the storm: authors' reply

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

EDITOR—Predictably, our editorial on the integration of complementary therapies (CAM) into the NHS failed to satisfy the enthusiasts or sceptics.¹

We do not think that the debate about appropriate evaluative methodologies has been resolved. For example, the distinction between contextual and specific effects is problematic, as is the choice of controls for complex interventions. The quality of the debate is not enhanced by rhetorical flourishes such as "scientific evidence ignored" in Canter and Ernst's letter, or the notion that we "appear nervous" at the National Institute for Health and Clinical Excellence (NICE) taking on the task of incorporating CAM into guidelines.² We would be delighted. We do not think that politics and scientific medicine are as distinct as they imply in their last sentence, as revealed in even a cursory look at the history of medicine or the social epistemology of science.^{3 4}

We think that pragmatic randomised controlled . . . [Full text of this article]

Academic Department of Primary Care, University of Bristol, Bristol BS6 6JL trevor.thompson@bristol.ac.uk

Centre for Health Sciences, Barts and the London, Queen Mary's School of Medicine and Dentistry, London E1 4AT

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