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Complementary and alternative medicine Medicine Pseudoscience Quackery Skepticism/critical thinking

How much of modern medicine is “evidence-based”? (briefly revisited)

I once blogged about an article attempting to address the very question in the title of this post, and I’ve also discussed in depth how messy the process of evidence-based medicine can be and why that provides an opening for purveyors of “alternative medicine” (my preferred term to describe it being “non-evidence-based medicine”) to respond to complaints about the lack of evidence supporting their favored woo with a hearty but fallacious tu quoque.

One of the favorite claims of purveyors of non-evidence-based “alternative” medicine is that modern scientific medicine is actually not very evidence-based. Various credulous supporters of such woo will often throw about claims that less than 50%, and perhaps as little as 15%, of modern medical therapies are based on valid scientific evidence. I had always wondered where that figure came from.

Now I know. I’m grateful to Steve Novella for telling me. It turns out that the 15% figure dates back nearly a half-century ago, all the way back to 1961 and wasn’t even looking at how much of medical practice was truly “evidence-based.”

Not surprisingly, Steve then goes on to show that the true figures are very much higher than the canard being thrown around by fans of unscientific, non-evidence-based therapies. Of course, even if the figure were 15% as is often claimed by some advocates of so-called “alternative” medical therapies, that figure would still be at least an order of magnitude greater than the evidence base supporting their favorite woo. That’s one difference between scientific, evidence-based medicine and woo. The other difference is that scientific medicine is always striving to increase the percentage of its therapies and practices that are based on science and well-designed clinical trials, abandoning therapies that are found not to work or not to work as well as newer therapies, while it is incredibly rare for an “alternative” therapy ever to be abandoned by its practitioners even when it is shown conclusively not to be efficacious.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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