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66-722: The Royal London Hospital for Integrated Medicine (formerly the Royal London Homoeopathic Hospital ) is a specialist alternative medicine hospital located in London , England and a part of University College London Hospitals NHS Foundation Trust . It is the largest public sector provider of complementary medicine in Europe. It is based in the Bloomsbury area of Central London , adjacent to Great Ormond Street Hospital . The London Homoeopathic Hospital

132-471: A 2018 interview with The BMJ , Edzard Ernst stated: "The present popularity of complementary and alternative medicine is also inviting criticism of what we are doing in mainstream medicine. It shows that we aren't fulfilling a certain need-we are not giving patients enough time, compassion, or empathy. These are things that complementary practitioners are very good at. Mainstream medicine could learn something from complementary medicine." Alternative medicine

198-472: A classification system for branches of complementary and alternative medicine that divides them into five major groups. These groups have some overlap, and distinguish two types of energy medicine: veritable which involves scientifically observable energy (including magnet therapy , colorpuncture and light therapy ) and putative , which invokes physically undetectable or unverifiable energy. None of these energies have any evidence to support that they affect

264-414: A corresponding increase in success of its treatments. In the 1970s, irregular practices were grouped with traditional practices of nonwestern cultures and with other unproven or disproven practices that were not part of biomedicine, with the entire group collectively marketed and promoted under the single expression "alternative medicine". Use of alternative medicine in the west began to rise following

330-446: A culture which have existed since before the advent of medical science, Many TM practices are based on "holistic" approaches to disease and health, versus the scientific evidence-based methods in conventional medicine. The 2019 WHO report defines traditional medicine as "the sum total of the knowledge, skill and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in

396-435: A method is proven to work, it eventually ceases to be alternative and becomes mainstream medicine. Much of the perceived effect of an alternative practice arises from a belief that it will be effective, the placebo effect , or from the treated condition resolving on its own ( the natural course of disease ). This is further exacerbated by the tendency to turn to alternative therapies upon the failure of medicine, at which point

462-431: A non-drug approach to treating some health conditions. In addition to the social-cultural underpinnings of the popularity of alternative medicine, there are several psychological issues that are critical to its growth, notably psychological effects, such as the will to believe, cognitive biases that help maintain self-esteem and promote harmonious social functioning, and the post hoc, ergo propter hoc fallacy. In

528-577: A particular culture, folk knowledge, superstition, spiritual beliefs, belief in supernatural energies (antiscience), pseudoscience, errors in reasoning, propaganda, fraud, new or different concepts of health and disease, and any bases other than being proven by scientific methods. Different cultures may have their own unique traditional or belief based practices developed recently or over thousands of years, and specific practices or entire systems of practices. Alternative medicine, such as using naturopathy or homeopathy in place of conventional medicine ,

594-536: A patient's condition even though the objective effect is non-existent, or even harmful. David Gorski argues that alternative treatments should be treated as a placebo, rather than as medicine. Almost none have performed significantly better than a placebo in clinical trials. Furthermore, distrust of conventional medicine may lead to patients experiencing the nocebo effect when taking effective medication. A patient who receives an inert treatment may report improvements afterwards that it did not cause. Assuming it

660-494: A person not diagnosed with science-based medicine may never originally have had a true illness diagnosed as an alternative disease category. Edzard Ernst , the first university professor of Complementary and Alternative Medicine, characterized the evidence for many alternative techniques as weak, nonexistent, or negative and in 2011 published his estimate that about 7.4% were based on "sound evidence", although he believes that may be an overestimate. Ernst has concluded that 95% of

726-582: A project funded by the CDC identified 208 condition-treatment pairs, of which 58% had been studied by at least one randomized controlled trial (RCT), and 23% had been assessed with a meta-analysis . According to a 2005 book by a US Institute of Medicine panel, the number of RCTs focused on CAM has risen dramatically. As of 2005 , the Cochrane Library had 145 CAM-related Cochrane systematic reviews and 340 non-Cochrane systematic reviews. An analysis of

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792-646: A research institute for integrative medicine (a member entity of the Cochrane Collaboration ). Medical schools are responsible for conferring medical degrees, but a physician typically may not legally practice medicine until licensed by the local government authority. Licensed physicians in the US who have attended one of the established medical schools there have usually graduated Doctor of Medicine (MD). All states require that applicants for MD licensure be graduates of an approved medical school and complete

858-541: A result of reforms following the Flexner Report of 1910 medical education in established medical schools in the US has generally not included alternative medicine as a teaching topic. Typically, their teaching is based on current practice and scientific knowledge about: anatomy, physiology, histology, embryology, neuroanatomy, pathology, pharmacology, microbiology and immunology. Medical schools' teaching includes such topics as doctor-patient communication, ethics,

924-545: A single-minded focus on the pathophysiological had diverted much of mainstream American medicine from clinical conditions that were not well understood in mechanistic terms, and were not effectively treated by conventional therapies. By 2001 some form of CAM training was being offered by at least 75 out of 125 medical schools in the US. Exceptionally, the School of Medicine of the University of Maryland, Baltimore , includes

990-955: A test which are not related to a patient's experience. These include patients reporting more favourable results than they really felt due to politeness or "experimental subordination", observer bias , and misleading wording of questions. In their 2010 systematic review of studies into placebos, Asbjørn Hróbjartsson and Peter C. Gøtzsche write that "even if there were no true effect of placebo, one would expect to record differences between placebo and no-treatment groups due to bias associated with lack of blinding ." Alternative therapies may also be credited for perceived improvement through decreased use or effect of medical treatment, and therefore either decreased side effects or nocebo effects towards standard treatment. Practitioners of complementary medicine usually discuss and advise patients as to available alternative therapies. Patients often express interest in mind-body complementary therapies because they offer

1056-624: A treatment to be harmful will perceive harmful effects after taking it. Placebos do not have a physical effect on diseases or improve overall outcomes, but patients may report improvements in subjective outcomes such as pain and nausea. A 1955 study suggested that a substantial part of a medicine's impact was due to the placebo effect. However, reassessments found the study to have flawed methodology. This and other modern reviews suggest that other factors like natural recovery and reporting bias should also be considered. All of these are reasons why alternative therapies may be credited for improving

1122-436: A wide range of health care practices, products, and therapies. The shared feature is a claim to heal that is not based on the scientific method. Alternative medicine practices are diverse in their foundations and methodologies. Alternative medicine practices may be classified by their cultural origins or by the types of beliefs upon which they are based. Methods may incorporate or be based on traditional medicinal practices of

1188-404: Is a profitable industry with large media advertising expenditures. Accordingly, alternative practices are often portrayed positively and compared favorably to "big pharma" . Risk%E2%80%93benefit ratio Analyzing a risk can be heavily dependent on the human factor. A certain level of risk in our lives is accepted as necessary to achieve certain benefits. For example, driving an automobile

1254-435: Is a risk many people take daily, also since it is mitigated by the controlling factor of their perception of their individual ability to manage the risk-creating situation. When individuals are exposed to involuntary risk (a risk over which they have no control), they make risk aversion their primary goal. Under these circumstances, individuals require the probability of risk to be as much as one thousand times smaller than for

1320-616: Is also home to a specialist library for complementary and alternative medicine. Alternative medicine Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility , testability , repeatability or evidence of effectiveness. Unlike modern medicine , which employs the scientific method to test plausible therapies by way of responsible and ethical clinical trials , producing repeatable evidence of either effect or of no effect, alternative therapies reside outside of mainstream medicine and do not originate from using

1386-512: Is based on belief systems not grounded in science. Alternative medical systems may be based on traditional medicine practices, such as traditional Chinese medicine (TCM), Ayurveda in India, or practices of other cultures around the world. Some useful applications of traditional medicines have been researched and accepted within ordinary medicine, however the underlying belief systems are seldom scientific and are not accepted. Traditional medicine

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1452-406: Is considered alternative when it is used outside its home region; or when it is used together with or instead of known functional treatment; or when it can be reasonably expected that the patient or practitioner knows or should know that it will not work – such as knowing that the practice is based on superstition. Bases of belief may include belief in existence of supernatural energies undetected by

1518-462: Is defined loosely as a set of products, practices, and theories that are believed or perceived by their users to have the healing effects of medicine, but whose effectiveness has not been established using scientific methods , or whose theory and practice is not part of biomedicine , or whose theories or practices are directly contradicted by scientific evidence or scientific principles used in biomedicine. "Biomedicine" or "medicine"

1584-403: Is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been "disproven". Anything classified as alternative medicine by definition does not have a proven healing or medical effect. However, there are different mechanisms through which it can be perceived to "work". The common denominator of these mechanisms is that effects are mis-attributed to

1650-525: Is really no such thing as alternative medicine, just medicine that works and medicine that doesn't", a notion later echoed by Paul Offit : "The truth is there's no such thing as conventional or alternative or complementary or integrative or holistic medicine. There's only medicine that works and medicine that doesn't. And the best way to sort it out is by carefully evaluating scientific studies—not by visiting Internet chat rooms, reading magazine articles, or talking to friends." Alternative medicine consists of

1716-480: Is sometimes derogatorily called " Big Pharma " by supporters of alternative medicine. Billions of dollars have been spent studying alternative medicine, with few or no positive results and many methods thoroughly disproven. The terms alternative medicine , complementary medicine , integrative medicine, holistic medicine , natural medicine , unorthodox medicine , fringe medicine , unconventional medicine , and new age medicine are used interchangeably as having

1782-710: Is that part of medical science that applies principles of biology , physiology , molecular biology , biophysics , and other natural sciences to clinical practice , using scientific methods to establish the effectiveness of that practice. Unlike medicine, an alternative product or practice does not originate from using scientific methods, but may instead be based on hearsay , religion, tradition, superstition , belief in supernatural energies, pseudoscience , errors in reasoning , propaganda, fraud, or other unscientific sources. Some other definitions seek to specify alternative medicine in terms of its social and political marginality to mainstream healthcare. This can refer to

1848-612: Is when alternative medicine is used together with mainstream functional medical treatment in a belief that it improves the effect of treatments. For example, acupuncture (piercing the body with needles to influence the flow of a supernatural energy) might be believed to increase the effectiveness or "complement" science-based medicine when used at the same time. Significant drug interactions caused by alternative therapies may make treatments less effective, notably in cancer therapy . Several medical organizations differentiate between complementary and alternative medicine including

1914-660: The United States Medical Licensing Examination (USMLE). There is a general scientific consensus that alternative therapies lack the requisite scientific validation , and their effectiveness is either unproved or disproved. Many of the claims regarding the efficacy of alternative medicines are controversial, since research on them is frequently of low quality and methodologically flawed. Selective publication bias , marked differences in product quality and standardisation, and some companies making unsubstantiated claims call into question

1980-569: The counterculture movement of the 1960s, as part of the rising new age movement of the 1970s. This was due to misleading mass marketing of "alternative medicine" being an effective "alternative" to biomedicine, changing social attitudes about not using chemicals and challenging the establishment and authority of any kind, sensitivity to giving equal measure to beliefs and practices of other cultures ( cultural relativism ), and growing frustration and desperation by patients about limitations and side effects of science-based medicine. At

2046-520: The "whole" person, in contrast to the supposed reductionism of medicine. Prominent members of the science and biomedical science community say that it is not meaningful to define an alternative medicine that is separate from a conventional medicine because the expressions "conventional medicine", "alternative medicine", "complementary medicine", "integrative medicine", and "holistic medicine" do not refer to any medicine at all. Others say that alternative medicine cannot be precisely defined because of

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2112-547: The CAM review used the more developed 2004 Cochrane database, while the conventional review used the initial 1998 Cochrane database. Alternative therapies do not "complement" (improve the effect of, or mitigate the side effects of) functional medical treatment. Significant drug interactions caused by alternative therapies may instead negatively impact functional treatment by making prescription drugs less effective, such as interference by herbal preparations with warfarin . In

2178-889: The Royal London Homeopathic Hospital by permission of King George VI in 1948. It was brought under the management of the Bloomsbury Health Authority in 1982 and it joined University College London Hospitals NHS Trust (now University College London Hospitals NHS Foundation Trust ) in 2002. The hospital was renamed the Royal London Hospital for Integrated Medicine in September 2010 to better reflect its activities. It stopped providing NHS-funded homeopathic remedies in April 2018. In 2024, King Charles III became patron of

2244-744: The UK National Health Service (NHS), Cancer Research UK , and the US Center for Disease Control and Prevention (CDC), the latter of which states that " Complementary medicine is used in addition to standard treatments" whereas " Alternative medicine is used instead of standard treatments." Complementary and integrative interventions are used to improve fatigue in adult cancer patients. David Gorski has described integrative medicine as an attempt to bring pseudoscience into academic science-based medicine with skeptics such as Gorski and David Colquhoun referring to this with

2310-417: The alternative therapies he and his team studied, including acupuncture, herbal medicine, homeopathy, and reflexology , are "statistically indistinguishable from placebo treatments", but he also believes there is something that conventional doctors can usefully learn from the chiropractors and homeopath: this is the therapeutic value of the placebo effect, one of the strangest phenomena in medicine. In 2003,

2376-408: The alternative treatment. A placebo is a treatment with no intended therapeutic value. An example of a placebo is an inert pill, but it can include more dramatic interventions like sham surgery . The placebo effect is the concept that patients will perceive an improvement after being treated with an inert treatment. The opposite of the placebo effect is the nocebo effect , when patients who expect

2442-496: The art of medicine, and engaging in complex clinical reasoning (medical decision-making). Writing in 2002, Snyderman and Weil remarked that by the early twentieth century the Flexner model had helped to create the 20th-century academic health center, in which education, research, and practice were inseparable. While this had much improved medical practice by defining with increasing certainty the pathophysiological basis of disease,

2508-445: The body in any positive or health promoting way. The history of alternative medicine may refer to the history of a group of diverse medical practices that were collectively promoted as "alternative medicine" beginning in the 1970s, to the collection of individual histories of members of that group, or to the history of western medical practices that were labeled "irregular practices" by the western medical establishment. It includes

2574-482: The claims of efficacy of isolated examples where there is evidence for alternative therapies. The Scientific Review of Alternative Medicine points to confusions in the general population – a person may attribute symptomatic relief to an otherwise-ineffective therapy just because they are taking something (the placebo effect); the natural recovery from or the cyclical nature of an illness (the regression fallacy ) gets misattributed to an alternative medicine being taken;

2640-637: The conclusions of only the 145 Cochrane reviews was done by two readers. In 83% of the cases, the readers agreed. In the 17% in which they disagreed, a third reader agreed with one of the initial readers to set a rating. These studies found that, for CAM, 38.4% concluded positive effect or possibly positive (12.4%), 4.8% concluded no effect, 0.7% concluded harmful effect, and 56.6% concluded insufficient evidence. An assessment of conventional treatments found that 41.3% concluded positive or possibly positive effect, 20% concluded no effect, 8.1% concluded net harmful effects, and 21.3% concluded insufficient evidence. However,

2706-477: The condition will be at its worst and most likely to spontaneously improve. In the absence of this bias, especially for diseases that are not expected to get better by themselves such as cancer or HIV infection , multiple studies have shown significantly worse outcomes if patients turn to alternative therapies. While this may be because these patients avoid effective treatment, some alternative therapies are actively harmful (e.g. cyanide poisoning from amygdalin , or

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2772-539: The diversity of theories and practices it includes, and because the boundaries between alternative and conventional medicine overlap, are porous, and change. Healthcare practices categorized as alternative may differ in their historical origin, theoretical basis, diagnostic technique , therapeutic practice and in their relationship to the medical mainstream. Under a definition of alternative medicine as "non-mainstream", treatments considered alternative in one location may be considered conventional in another. Critics say

2838-635: The dominant health care system. They are used interchangeably with traditional medicine in some countries." The Integrative Medicine Exam by the American Board of Physician Specialties includes the following subjects: Manual Therapies , Biofield Therapies , Acupuncture , Movement Therapies, Expressive Arts, Traditional Chinese Medicine , Ayurveda , Indigenous Medical Systems , Homeopathic Medicine , Naturopathic Medicine , Osteopathic Medicine , Chiropractic , and Functional Medicine . Traditional medicine (TM) refers to certain practices within

2904-482: The established science of how the human body works; others appeal to the supernatural or superstitious to explain their effect or lack thereof. In others, the practice has plausibility but lacks a positive risk–benefit outcome probability. Research into alternative therapies often fails to follow proper research protocols (such as placebo -controlled trials, blind experiments and calculation of prior probability ), providing invalid results. History has shown that if

2970-424: The expression is deceptive because it implies there is an effective alternative to science-based medicine, and that complementary is deceptive because it implies that the treatment increases the effectiveness of (complements) science-based medicine, while alternative medicines that have been tested nearly always have no measurable positive effect compared to a placebo . Journalist John Diamond wrote that "there

3036-509: The histories of complementary medicine and of integrative medicine . Before the 1970s, western practitioners that were not part of the increasingly science-based medical establishment were referred to "irregular practitioners", and were dismissed by the medical establishment as unscientific and as practicing quackery. Until the 1970s, irregular practice became increasingly marginalized as quackery and fraud, as western medicine increasingly incorporated scientific methods and discoveries, and had

3102-485: The hospital, a role Queen Elizabeth II had filled until her death in 2022. The Royal London Hospital for Integrated Medicine offers clinical services including complementary cancer treatments, allergy services, acupuncture , rheumatology , weight loss management, sleep management , musculoskeletal medicine, and stress management . It has an education department which offers full and part-time courses in complementary medicine for registered health professionals. It

3168-781: The intentional ingestion of hydrogen peroxide ) or actively interfere with effective treatments. The alternative medicine sector is a highly profitable industry with a strong lobby, and faces far less regulation over the use and marketing of unproven treatments. Complementary medicine ( CM ), complementary and alternative medicine ( CAM ), integrated medicine or integrative medicine ( IM ), and holistic medicine attempt to combine alternative practices with those of mainstream medicine. Traditional medicine practices become "alternative" when used outside their original settings and without proper scientific explanation and evidence. Alternative methods are often marketed as more " natural " or " holistic " than methods offered by medical science, that

3234-547: The lack of support that alternative therapies receive from medical scientists regarding access to research funding , sympathetic coverage in the medical press , or inclusion in the standard medical curriculum . For example, a widely used definition devised by the US NCCIH calls it "a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine" . However, these descriptive definitions are inadequate in

3300-573: The loose terminology to give the appearance of effectiveness). Loose terminology may also be used to suggest meaning that a dichotomy exists when it does not (e.g., the use of the expressions "Western medicine" and "Eastern medicine" to suggest that the difference is a cultural difference between the Asian east and the European west, rather than that the difference is between evidence-based medicine and treatments that do not work). Alternative medicine

3366-492: The maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness." When used outside the original setting and in the absence of scientific evidence, TM practices are typically referred to as "alternative medicine". Holistic medicine is another rebranding of alternative medicine. In this case, the words balance and holism are often used alongside complementary or integrative , claiming to take into fuller account

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3432-435: The pejorative term " quackademia ". Robert Todd Carroll described Integrative medicine as "a synonym for 'alternative' medicine that, at its worst, integrates sense with nonsense. At its best, integrative medicine supports both consensus treatments of science-based medicine and treatments that the science, while promising perhaps, does not justify" Rose Shapiro has criticized the field of alternative medicine for rebranding

3498-644: The period of reorganization within medicine (1965–1999) was reported as showing that the medical profession had responded to the growth of CAM in three phases, and that in each phase, changes in the medical marketplace had influenced the type of response in the journals. Changes included relaxed medical licensing, the development of managed care , rising consumerism, and the establishment of the USA Office of Alternative Medicine (later National Center for Complementary and Alternative Medicine, currently National Center for Complementary and Integrative Health). Mainly as

3564-427: The present-day when some conventional doctors offer alternative medical treatments and introductory courses or modules can be offered as part of standard undergraduate medical training; alternative medicine is taught in more than half of US medical schools and US health insurers are increasingly willing to provide reimbursement for alternative therapies. Complementary medicine (CM) or integrative medicine (IM)

3630-615: The same meaning and are almost synonymous in most contexts. Terminology has shifted over time, reflecting the preferred branding of practitioners. For example, the United States National Institutes of Health department studying alternative medicine, currently named the National Center for Complementary and Integrative Health (NCCIH), was established as the Office of Alternative Medicine (OAM) and

3696-446: The same practices as integrative medicine. CAM is an abbreviation of the phrase complementary and alternative medicine . The 2019 World Health Organization (WHO) Global Report on Traditional and Complementary Medicine states that the terms complementary and alternative medicine "refer to a broad set of health care practices that are not part of that country's own traditional or conventional medicine and are not fully integrated into

3762-402: The same situation under their perceived control (a notable example being the common bias in the perception of risk in flying vs. driving). Evaluations of future risk can be: For research that involves more than minimal risk of harm to the subjects, the investigator must assure that the amount of benefit clearly outweighs the amount of risk. Only if there is a favorable risk–benefit ratio may

3828-644: The same time, in 1975, the American Medical Association , which played the central role in fighting quackery in the United States, abolished its quackery committee and closed down its Department of Investigation. By the early to mid 1970s the expression "alternative medicine" came into widespread use, and the expression became mass marketed as a collection of "natural" and effective treatment "alternatives" to science-based biomedicine. By 1983, mass marketing of "alternative medicine"

3894-832: The same way as for conventional therapies, drugs, and interventions, it can be difficult to test the efficacy of alternative medicine in clinical trials . In instances where an established, effective, treatment for a condition is already available, the Helsinki Declaration states that withholding such treatment is unethical in most circumstances. Use of standard-of-care treatment in addition to an alternative technique being tested may produce confounded or difficult-to-interpret results. Cancer researcher Andrew J. Vickers has stated: Contrary to much popular and scientific writing, many alternative cancer treatments have been investigated in good-quality clinical trials, and they have been shown to be ineffective. The label "unproven"

3960-649: The science of physics, as in biofields, or in belief in properties of the energies of physics that are inconsistent with the laws of physics, as in energy medicine. Substance based practices use substances found in nature such as herbs, foods, non-vitamin supplements and megavitamins, animal and fungal products, and minerals, including use of these products in traditional medical practices that may also incorporate other methods. Examples include healing claims for non-vitamin supplements, fish oil , Omega-3 fatty acid , glucosamine , echinacea , flaxseed oil , and ginseng . Herbal medicine , or phytotherapy, includes not just

4026-531: The scientific method, but instead rely on testimonials , anecdotes , religion, tradition, superstition , belief in supernatural " energies ", pseudoscience , errors in reasoning , propaganda, fraud, or other unscientific sources. Frequently used terms for relevant practices are New Age medicine , pseudo-medicine , unorthodox medicine , holistic medicine , fringe medicine , and unconventional medicine , with little distinction from quackery . Some alternative practices are based on theories that contradict

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4092-518: The use of plant products, but may also include the use of animal and mineral products. It is among the most commercially successful branches of alternative medicine, and includes the tablets, powders and elixirs that are sold as "nutritional supplements". Only a very small percentage of these have been shown to have any efficacy, and there is little regulation as to standards and safety of their contents. The United States agency National Center for Complementary and Integrative Health (NCCIH) has created

4158-637: Was established in Golden Square , Soho , in 1849. Frederic Hervey Foster Quin , the first homeopathic physician in England, had been instrumental in the founding of the hospital. It moved to its present site in Great Ormond Street in 1859, the year when Quin took the chair of therapeutics and materia medica in the medical school. The hospital joined the NHS as a teaching hospital becoming

4224-482: Was renamed the National Center for Complementary and Alternative Medicine (NCCAM) before obtaining its current name. Therapies are often framed as "natural" or "holistic", implicitly and intentionally suggesting that conventional medicine is "artificial" and "narrow in scope". The meaning of the term "alternative" in the expression "alternative medicine", is not that it is an effective alternative to medical science (though some alternative medicine promoters may use

4290-523: Was so pervasive that the British Medical Journal ( BMJ ) pointed to "an apparently endless stream of books, articles, and radio and television programmes urge on the public the virtues of (alternative medicine) treatments ranging from meditation to drilling a hole in the skull to let in more oxygen". An analysis of trends in the criticism of complementary and alternative medicine (CAM) in five prestigious American medical journals during

4356-414: Was the cause without evidence is an example of the regression fallacy. This may be due to a natural recovery from the illness, or a fluctuation in the symptoms of a long-term condition. The concept of regression toward the mean implies that an extreme result is more likely to be followed by a less extreme result. There are also reasons why a placebo treatment group may outperform a "no-treatment" group in

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