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Reviews TV

Alternative Medicine

BMJ 2006; 332 doi: (Published 26 January 2006) Cite this as: BMJ 2006;332:241

Rapid Response:

Missing paragraph

My published review (BMJ, 28th January, p 241) jumped from the first
to the third episode, omitting a paragraph about the second one on
"Healing" that was shown yesterday. I gave the whole series a 4-star
rating because it showed "that it was possible to apply properly designed
clinical trials to alternative therapies". This gives the impression that
I approved the trials described in each episode, which is certainly not
the case.

The programme about spiritual healing demonstrated the power of
placebo. Painful conditions are cured as effectively by fake surgery, or
fake healers, as by the real thing. But the other important message is
that to avoid bias and obtain reliable results the trial requires
meticulous planning. The allocation of volunteers to test or control
group should be randomised, and this allocation should (as far as
possible) be effectively concealed from the volunteers, from those giving
the treatment, and from those assessing the results. I was therefore
shocked by a general practitioner (Dr Michael Dixon) who explains that he
encourages his patients to consult a healer, because he has done research
to show that spiritual healers really are effective. His clinical trial
involved over 50 patients from his practice who were either sent to a
healer, or put on a waiting list. About 70% of those attending the healer
were improved, but only about 30% of the non-treated "controls": he says
this difference is "significant".

The result is not significant, but entirely predictable, because one
group expected to be healed, but the other did not. The results tell us
nothing about the healing power of spiritual healers compared with
placebo. Professor Sykes commended Dr Dixon for his courage in setting up
this trial, but she should have warned anybody who might follow his
example that, unless the trial is well-designed, it will be a waste of
time and money.

I hope this explanation will reassure readers that HealthWatch
promotes only properly-designed trials, and does not endorse the
conclusions of unrandomised, unblinded trials of either orthodox ot
alternative medicine, especially when they seek to show the efficacy of
therapies in which the placebo effect is known to be extremely strong.

Competing interests:
I was the author of the article being discussed

Competing interests: No competing interests

16 February 2006
John S Garrow
retired physician and former chairman of HealthWatch
93 Uxbridge Road, Rickmansworth, WD3 7DQ