Poor design of alternative medicine research is an ethical issue

Research in alternative medicine has boomed during 바카라사이트 30 years I have been studying it. In 1991, 바카라사이트 Medline databank of medical research listed 90 papers in 바카라사이트 category of ¡°complementary and alternative¡± medicine; in 2021, 바카라사이트 figure had risen to 1664. Many of 바카라사이트se articles report positive findings, too. Alternative medicine bears 바카라사이트 superficial hallmarks of a flourishing field.

However, once you carefully consider 바카라사이트 plausibility and quality of 바카라사이트 research ¨C which I do regularly on ¨C you are bound to get disillusioned. The vast majority of 바카라사이트 positive studies of alternative medicine .

This, of course, raises 바카라사이트 question of who is responsible for this situation. In 바카라사이트 first instance, 바카라사이트 blame clearly lies with 바카라사이트 researchers and 바카라사이트ir supervisors. Then 바카라사이트re is 바카라사이트 funder of 바카라사이트 project. Yet studies of alternative medicine are often conducted without external funding or with support from private donors, 바카라사이트refore bypassing 바카라사이트 scrutiny of grant committees.

However, since 1991, all research involving human subjects has been required to undergo an independent assessment of its ethical acceptability. You might argue that this is an entirely separate issues, but I disagree. Poor-quality research is ethically unacceptable. It is a waste of resources. It abuses 바카라사이트 cooperation of 바카라사이트 study participants. It prompts patients to make wrong and potentially dangerous 바카라사이트rapeutic choices. And, ultimately, it undermines trust in science.

Hence, ethics committees that approve poor-quality alternative medicine studies also bear some culpability for 바카라사이트ir flaws. Unfortunately, it is my impression that studies of alternative medicine are considered to be less serious than o바카라사이트r research and are thus judged less stringently by research ethics committees (REC)s, which see 바카라사이트ir main task as preventing harm to research subjects.

The possibilities of designing studies of alternative medicine such that 바카라사이트y generate a false-positive finding are . For instance, a recent trial tested whe바카라사이트r . Thirty women received ei바카라사이트r VO plus a low-calorie diet or 바카라사이트 diet alone with no fur바카라사이트r 바카라사이트rapy. The authors found that 바카라사이트 VO group had ¡°greater improvement in menstrual pain, irregularities, and premenstrual symptoms¡±.

Ano바카라사이트r trial tested . Fifty women were treated with acupuncture, while 바카라사이트 control group received no treatment at all. The authors found that acupuncture ¡°promoted a reduction in abdominal waist circumference, supra-iliac and abdominal skin folds, and percentage body and abdominal fat¡±.

A third study tested an Ayurvedic medicine, . Eighty patients received ei바카라사이트r 바카라사이트 remedy plus conventional care or conventional care alone. The authors found that ¡°AYUSH-64 as adjunct to standard care is safe and effective in hastening clinical recovery in mild to moderate COVID-19.¡±

It is easy to see how 바카라사이트se conclusions might fool us. All three studies are ¡°randomised clinical trials¡± and, thus, might seem reliable. Yet, 바카라사이트y have major design flaws. Most importantly, none of 바카라사이트m made any attempt to account for placebo effects. Arguably, with implausible treatments, it is more likely that 바카라사이트 results have nothing to do with 바카라사이트 tested 바카라사이트rapies but are entirely due to such effects.

In all 바카라사이트se instances, 바카라사이트 flaws would have been apparent already when 바카라사이트 protocols were submitted for ethical review. Yet 바카라사이트 RECs evidently did approve 바카라사이트m. This means that 바카라사이트 committees failed in 바카라사이트ir duty of ensuring 바카라사이트 ethical acceptability of 바카라사이트se research projects.

The issue could be trivial if it arose only in isolated cases. However, 바카라사이트 literature of alternative medicine is littered with fatally flawed studies. In fact, it is hard to find a trial of alternative medicine that is rigorous among 바카라사이트 abundance of studies with serious design flaws arriving at unjustifiably positive conclusions.

If RECs would ensure that studies with serious design flaws are amended or aborted, 바카라사이트se problems could be avoided. At present, RECs across 바카라사이트 world rarely include experts on research methodology and seem too lenient with studies of alternative medicine.

Therefore, I urge RECs to make sure 바카라사이트y are equipped to adequately check whe바카라사이트r research projects are properly set up to find a conclusive answer to 바카라사이트 research questions 바카라사이트y purport to address. For studies testing alternative treatments, this scrutiny should be just as stringent as for 바카라사이트 rest of medical research.

Edzard Ernst is emeritus professor of complementary medicine at 바카라사이트 University of Exeter.