Research in CAM – Are Randomized Controlled Trials the Absolute Truth?

Background Recent years have witnessed a growth in awareness and use among people regarding complementary medicine. Nevertheless, many point to the urgent need for methodologically sound studies of these treatments effectiveness. According to Evidence Based Medicine criteria, randomized controlled trials (RCT) should be the gold standard. Yet, most of the published researches are descriptive survey studies or personal experiences, while only the minority are RCT.

Objective To examine attitudes among key figures in the health policy realm about research in CAM.

Methodology The research was based on fourty four in-depth interviews with senior figures within the Israeli health system such as: Ministry of health officers, hospital heads, deans of medical schools, practitioners and physicians.

Findings Almost half of the interviewees, including physicians and therapists, claimed that it's difficult to investigate CAM according to RCT methodology. They suggested that CAM studies should be done according to methods that match CAM treatments philosophy from numerous reasons. Other interviewees, especially physicians, claimed that CAM studies should be done according to EBM criteria (mainly RCT), claiming that problems usually mentioned, like different philosophy or lack of funding, are just excuses.

Conclusions All interviewees agreed on the importance of scientific studies of CAM but there was no consensus on the strict need to use RCT. Most agreed that conducting RCT studies is the most efficient for CAM to be accepted by physicians, while claiming that such studies require funding, longer time to complete and a shift in the perspective within both medical and CAM communities.