Re: New attack on herbal medicine by Prof Ernst and colleagues

"You would be forgiven for thinking that this was a review of dozens or even hundreds of studies. But just three? Yes, although Prof Ernst and colleagues started their review with a hopeful 1345 references in the peer reviewed literature, their particular and harsh inclusion criteria managed to whittle away some 98.8% of the references leaving just 0.2% - i.e. three! How the journal allowed this paper to be titled a ‘systematic review’ and how they allowed the title to include its relevance to ‘any indication’—is anyone’s guess."

Actually, Ernst and his colleagues _did_ review all those papers.

"Out of 1,300 papers in the scientific literature, only three were properly controlled, randomised trials, and one of those was as yet unpublished. In the treatment of osteoarthritis of the knee and the relief of cancer chemotherapy side-effects, the herbal mixtures did not work at all. In irritable bowel syndrome, they were better than nothing, but the patients who did best were those on a standardised herbal medicine, not on an individualised cocktail."


http://www.guardian.co.uk/medicine/story/0,,2183054,00.html


One can publish anecdotes, single case reports and uncontrolled trials and get all kinds of hopeful-looking results that can't be replicated, and wind up deceiving users of herbs. The same "harsh" criteria for quality research apply to pharmaceutical drug studies as well.

Ernst's study questions herbal "cocktails", where a slew of ingredients are prepared for patients by "herbalists", many of whom are unlicensed and have dubious qualifications (and who are viewed with suspicion by herbal professionals). The more ingredients you have in one of these herbal stews, the more chance of allergic reactions, interactions (between ingredients and with other drugs the patient may be taking) and the greater the chance that some adulterated or toxic ingredient will slip in (thanks to lax manufacturing rules in China, for instance).



Tweet