The Economics of Medical Science

 Complementary medicine is commonly dismissed with the words "There is no scientific proof that it works", as if that is the end of the matter. But it is not.

Leaving aside the nitty point that there is no such thing as "scientific proof" because, technically no scientific hypothesis is proven, the best that a hypothesis can do is not-yet-disproven, according to the great philosopher of science, Karl Popper, there is often a fair amount of scientific literature covering topics in complementary medicine such as manipulation or herbal medicine. Some of this is poor quality but not all. Some complementary research is very carefully carried out - so why is it not taken seriously?

One of the problems is the size of the trial. To get any credibility in modern medical science you need a massive number of subjects in the trial, the more the merrier. A typical randomised controlled trial will have n=20,000, where n is the number of subjects in the trial, because you need that many to get robust statistics. So, for comparison, if your aunt Vera recovered from her cold after eating a hot curry, n=1. Aunt Vera lacks credibility. 

Of course, to do a trial where n=20,000 costs a lot of money. there will be professors, doctors, nurses, data gatherers and statistician aplenty all working on the project. This will cost many millions of pounds, and the only people who can find this money are pharmaceutical corporations. They can pay the salaries, providing that there is a licensed pharmaceutical at the end of the process, because they will get a 20 year monopoly on a patented licensed new medicine. 

It is perfectly possible to do a similar sized randomised controlled trial on, say, Saffron in early dementia. At the end of the trial, it may be found that Saffron emerges with evidence of benefit on memory performance. Great, say the families of people with memory problems. Great also say the competitors of the group that did the research. Without having to pay out for the research, the competitors can sell in the reflected glory of the research, because Saffron cannot be patented.

So this is why there is not so much scientific evidence for complementary therapies as there is for patented, synthetic medicines. 

Absence of evidence is not evidence of absence.