pragmatic trials

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That I’m not a fan of the National Center for Complementary and Integrative Health (NCCIH, formerly known as the National Center for Complementary and Alternative Medicine, or NCCAM) should come as no surprise to anyone. Basically, from its very inception as the Office of Alternative Medicine in the early 1990s to its growth to large…

Practitioners of “complementary and alternative medicine” (CAM) have a love-hate relationship with randomized clinical trials (RCTs). Actually, it’s mostly hate, but they do crave the validation that only randomized clinical trials can provide within the paradigm of evidence-based medicine (EBM). Yes, I intentionally said EBM, rather than science-based medicine (SBM), because, as I’ve described so…

I’m not alone in pointing this out, but if there’s one thing about research and clinical trials into “complementary and alternative medicine” (CAM) that has become very apparent to me over the years, it’s that the more rigorous the study the less likely it is to show an effect. In normal research, the usual progression…