OU on the BBC: The Other Medicine - Programme 2: How Do We Find Out If It Works?

BBC There’s no shortage of people who’ll tell you that CAM works for them. But anecdote is not the same as the sort of evidence that comes from testing new pharmaceuticals in rigorous clinical trials. And in today’s cash-strapped NHS, value for money is crucial. How should we establish whether CAM therapies “work”, and is the scientific trial the only reliable method?

We visit one of the new research institutes in the UK which have been set up to throw some light on the effectiveness of CAM. We follow the progress of some examples of CAM therapy trials, shedding light on the challenges of this sort of “test”. Despite a shortage of research funding, there is a growing body of rigorous, published, scientific evidence on CAM. We hear from Dr Richard Horton, editor of The Lancet, who has published several CAM trials recently, including a review of homeopathy which suggests it works better than would be expected from the placebo effect alone. Why, for someone like Dr Horton, is the randomised controlled trial (RCT), published in a peer-reviewed journal, the gold standard of evidence?

Several new journals are now devoted exclusively to “alternative” medicine – why is there a need for these sorts of journals? Are the CAM researchers, such as Professor Edzard Ernst at Exeter or George Lewith at Southampton, equally convinced that RCT’s are the bottom line? Is there any truth in the assertion by some therapists that CAM is simply not suitable for testing in controlled trials? From the evidence we have, we assess how some CAM therapies measure up against the accepted scientific yard stick- it’s a mixed picture.

Many therapists and CAM users argue that there are other, more appropriate, ways to measure the effectiveness of their therapies. NHS researchers are now assessing therapies as they are really delivered, in their normal settings. For example, Kate Thomas has spent nearly 20 years researching complementary therapies and is now deputy director of the Medical Care Research Unit at the University of Sheffield. In her research, she is asking a different sort of question from the usual controlled trial: “Do patients who have access to acupuncture for their back pain do better than those who don’t?” We explore a range of possible approaches to CAM research, and ask how CAM research is likely to develop in future.

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First broadcast: Tuesday 21 Sep 2004 on BBC Radio 4

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