Adam Smith

Science and Communications Officer, ANH-Intl

KEY POINTS

  1. The UK's first Professor of Complementary Medicine, Edzard Ernst, has retired and is seeking a successor
  2. In several interviews with UK and international publications, he appears to be raising his public profile
  3. Despite his high visibility, his research methods and conclusions are extremely questionable
  4. ANH-Intl awaits his next move with interest

     

Edzard Ernst, Professor of Complementary Medicine at Peninsula Medical School in Devon, UK, became an ex-Prof when he retired in May.  According to a recent interview in the UK's Telegraph newspaper, his post will be retained and Ernst is helping to find a successor.  It will be interesting to see what Ernst does next, especially since he can't wait to be “Outspoken about quackery and charlatans.  I look forward to that.  Hopefully, UK libel law has [sic] changed by then". 


After this interview and another in the UK's Guardian newspaper, Ernst has now taken his opinions on natural healthcare to an international audience, via an interview in New Scientist magazine (login required).

Another change of heart?

Interestingly, between the end of July, when the Guardian piece appeared, and the 23rd August that saw publication of the New Scientist interview, he has gone from proclaiming that homeopathic efficacy is "absolutely nil" to saying that "I still think that homeopathy works, the question is: why?...It's a powerful placebo effect".  Even in the Telegraph piece, published a whole day earlier on 22nd August, he said no positive conclusions can be drawn about homeopathy from the published research.  As we've said before: which is it, Edzard?  Even if you do think that the placebo effect entirely accounts for homeopathy's positive results, that's a bit different to saying that there are no positive results.  Neither does it begin to explain homeopathy's usefulness in animals.

Nice flip-flops!

But we digress.  Ernst is no stranger to U-turns on the effectiveness of natural healthcare.  Not only that, but, as he is at pains to mention in every interview, he once worked in a homeopathic hospital, and he is on record as saying that "As a kid I was treated homoeopathically...This made a big impression on me".  This was before he became the fearless Inquisitor-General of natural healthcare for whom evidence-based medicine (EBM) is the one true guiding star. 

A word on Ernst's methodology

As we have pointed out before, the reason why Ernst's assessments of natural healthcare are often negative is not simply that these healing techniques shrivel under the harsh light of scientific scrutiny.  Ernst's methods, which we see applied in the same manner over and over to many different forms of natural healthcare, involve selecting what he deems to be high-quality studies and performing meta-analyses or systematic reviews on them.  Studies of studies, in other words. 


The problem comes when trying to separate out the 'specific therapeutic effect' from the plethora of related phenomena that must also be considered, and which together make up the 'total therapeutic effect' (see Figure 1).

 


Figure 1. Variables operative during clinical trials that contribute to the 'total therapeutic effect'


The RCT can only separate out the specific therapeutic effect from the total effect if all of the other phenomena in the Figure 1 are independent of each other, and operate the same under experimental and real-life conditions.  But just think of the practitioner–patient relationship for a moment.  As we said in our earlier piece, "Crucially, the bio-physical-energetic interactions between practitioner and patient, as well as internal neurophysiological and metabolic processes, are likely to be very different in these two contrasting circumstances...it is perhaps no wonder that Ernst finds that treatment effects are so often lost in the overall noise of the experiment – falling foul to the netherworld of statistical insignificance."


We submit that it is no coincidence that many of Ernst's studies have been negative.

Fantastic Mr Fix

In addition, never forget that in our opinion, Ernst is not above a bit of figure-fudging.  At one point, he and his colleagues rejected 99.8% of the available evidence on herbal medicine and concluded that "there is no convincing evidence that it is effective in any indication" [1].


Can you imagine the response if anyone involved in natural healthcare examined any aspect of orthodox medicine with the same laughable methods?  There would be an outcry, and rightly so.  What's so dangerous about it is that Ernst's propaganda is taken seriously by commentators in the media and presented to the public as if it represents some kind of unquestionable, scientific truth, providing useful ammunition for the anti-nature skeptics to continue their campaign.  Much like Ernst's entire career, in fact.

So what's next?

Having said that, Ernst's closing comments to the New Scientist may be encouraging.  "If...the clinical evidence shows that my present conclusions are wrong then I will change my mind again...it is a sign of intelligence to change your mind when the evidence changes".  It will be interesting to see what happens now that Ernst is a commentator on natural healthcare, rather than a researcher.


For the full story, read our previous expose, entitled Professor Edzard Ernst: Master Trickster Of Evidence-Based Medicine? 


[1] Guo R et al. Postgrad Med J 2007;83:633–37.

 

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