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Alternative Medicine: A Mirror Image for Scientific Medicine
- Jan P. Vandenbroucke, MD, PhD; and
- Anton J.M. de Craen, PhD
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IN RESPONSE:
We are grateful that Dr. Ernst points to new literature that includes reanalyses of the original meta-analysis on homeopathy by Linde and colleagues (1). However, in our paper, we already pointed to one reanalysis (2) that casts doubt on the robustness of the original. We also acknowledged that such reanalyses have been ongoing because scientists cannot believe the results of the original and therefore try to prove that the original was “methodologically flawed.” Verdicts that a study (or a meta-analysis) is flawed are in this case based on reasoning and logic only because there is no “evidence” for “methodologic flaws.”
This reasoning fits very well with the crossword analogy that we proposed. One entry in the crossword holds that infinite solutions cannot possibly have chemical activity; this entry is very well entrenched in physics, chemistry, and biology. In line with this entry, we prefer the entry interpreting the meta-analysis (or the original studies) as flawed, which has its own arguments embedded in reasoning and logic, as indicated by Dr. Ernst and others. Of course, this is not always immediately apparent. When the original meta-analysis on homeopathy was published, many were surprised and wondered whether there was anything in it. Gradually, however, it became clear that the findings were less robust than they originally were thought to be. In this way, all entries do now fit, and this “consilient” (3) fitting gives us an argument that endorses both methodologic and basic science reasoning.
Jan P. Vandenbroucke, MD, PhD
Anton J.M. de Craen, PhD
Leiden University Medical Center
2300 RC Leiden, the Netherlands
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
