Customer Reviews: Read 17 more reviews...
 A very therapeutic book November 25, 2008
1 out of 1 found this review helpful
This is a very well-structured and well-written book. It opens by considering the case for evidence-based medicine before moving onto its four main chapters. These deal primarily with acupuncture, homeopathy, chiropractic and herbal medicine. Where there is favourable evidence then this will be mentioned.
The book then concludes by examining some of the more general issues including an analysis of the main culprits who promote alternative medicine. In addition, there is an appendix which gives a one page analysis to about 30 other therapies. I would imagine that this would cover more or less everything which someone is likely to encounter.
I read this book in parallel with 'Suckers' by Rose Shapiro and would highly recommend anyone else to do likewise. If you have a particular interest in osteopathy then Shapiro's book considers it in greater depth. Another book which might be worth investigating would be 'Irrationality' by Stuart Sutherland. One of the things which he highlights is the widespread statistical illiteracy which is found within the (orthodox) medical profession. He argues that a good understanding of statistics is one of the few things which gives some protection against making irrational decisions.
 Failed to achieve it's potential - Must try harder. November 22, 2008
2 out of 2 found this review helpful
I was delighted to get this book in my hands... I had waited long enough. I got reading at once, but found as I went along that my initial enthusiasm waned. It's not that it's badly written, or doesn't cover an important subject, it's just that it didn't quite hit the intended spot, and I expected so much more.
The premise is good - to scientifically examine the evidence base for alternative remedies. It covers acupuncture, homeopathy, chiropractic and herbal medicine, as well as having a section summary of other types of CAM (this was very useful). I thought the main sections didn't explore the topic thoroughly enough, such as the herbal medicine chapter, where only some preparations are mentioned and in no great depth. There also seemes to be a lot of repetition (sometimes with things popping up in a different chapter entirely), as though Ernst and Singh thought I hadn't been paying attention the first time and I needed constant reminders. In my opinion it was inadequately referenced, and a list of "further reading" will not do in place of proper citations for a book of this type.
The ground was generally well covered, and I was left more enlightened and informed than before I read the book, but as I say I was a wee bit disappointed. Why? Maybe it's my fault in expecting too much. After reading such wonderful books such as "Suckers" by Rose Shapiro, I felt a bit deflated, rather like I'd gone to watch Manchester United only to find that Rooney, Berbatov and Ronaldo had been left off the team sheet, and United ended up drawing with Fulham. Perhaps if I had read this book before Shapiro's I would have thought differently.
I did find the narrative flow somewhat stilted. Was this the result of having two authors? Some of the sections read like the conclusions to a scientific paper, and I detect Ernst's hand in these. But this is a book for more general consumption, and it would have more appeal by being more direct in parts and certainly much more punchy.
I hate to give a rather lukewarm review to a book by some of my "heroes" in the fight against quackery, but I must be honest and tell it like I see it. Nevertheless, this is a very important book and deserves to be read widely. I hope it is and that universities, colleges and academic libraries will stock it, so anyone thinking of careers in alternative medicine can have the chance to read it too.
 Poorly researched October 17, 2008
0 out of 25 found this review helpful
Singh has not researched this much and has been prejudiced by Ernst's coloured and flawed research
An important book September 7, 2008
3 out of 3 found this review helpful
This book shows how evidence based medicine has made an incalculable contribution to health, science and thus the quality of life we experience today. Examples include how it was not just the treatment that Florence Nightingale provided but that fact that she backed up her treatment with exacting statistical analysis to convince skeptical authorities to the merits of her methods.
How it was systematic study of the effects of diet on sailors that meant that British sailors were fed on a diet that included citrus fruit eradicating scurvy, an affliction that was responsible for 90% of the deaths of sailors at the time, ( and as an aside was perhaps a major reason for the power of the British navy and subsequent empire - yeah, a systematic study on oranges).
The book further explains how before these systematic methods of evidence based medicine, philosophic theories such as balance (of bodily fluid) were the prevailing method (sound familiar?), and that it was this non-systematic approach that meant that treatment like blood-letting prevailed for so long (and likely killed George Washington in the process).
The latter chapters then explain how alternative medicine tends to fail under the watchful eye of evidence based medicine (which as explained is the only true test) but crucially where evidence based medicine does show potential for certain 'alternative' treatments, the writers acknowledge that too.
Remember, the authors are concerned with your health, and the crucial question they are asking: does it work?
Uncomplimentary medicine August 19, 2008
11 out of 22 found this review helpful
The book is impeccably constructed and written with wonderful fluency - I would expect nothing less from somebody with Singh's skills and experience. The authors weave together lots of little stories, biographies, and anecdotes into a very palatable confection. This is all about 'evidence-based' medicine and how it shines its light over our culture. By the final page this apparent objectivity reveals itself as the belief that 'the concept of an alternative type of medicine is a throwback to the Dark Ages' and 'the public is being misled again and again'.
Written by such highly qualified men, it is all highly plausible, and if I hadn't been selectively using aspects of what I prefer to call 'complementary medicine' since the late 1970's I would probably accept it. My problem with the book is that it simply doesn't accord with my experience.
I cannot be an apologist for the whole field - there are some pretty stupid people in the world, some of them unfortunately do work in complementary medicine, and the neophilia of the media has done more harm than good - but the therapists I have used have been professional, knowledgeable, fairly priced and highly effective. Nor would I devalue the orthodox medical paradigm - I am deeply grateful for some of he spectacular benign effects of modern medicine as well as the kindness of GP's. But Ernst and Singh seem to misrepresent what is happening in the world by perceiving it through a highly limited filter and then being suspiciously selective in their tale-telling. They rely on the apparent finality of new statistical methods and the convenience of attributing pretty much everyting else to the placebo effect to give weight to their argument, and conveniently miss out any accurate statisitics on just how satisfied most the clients of this 40 billion pound worldwide phenomenon really are, or why they really use such therapies.
Most conveniently they do not address the complex issue of people in an affluent post-modern society being free to make choices when orthodox medicine fails them in some way. Iatrogenic illness, the painful side-effects of superficially effective drugs, the fact that most treatment for chronic illness is palliative at best, and so on, are far more potent incentives for people to look for alternatives than Ernst and Singh care to admit. If, like me, they then find that a few sessions with a good osteopath are much cheaper than a lifetime on painkillers they may use that method again. The authors seem fairly sniffy about the potential synergistic benefits to health of time, kindness, informal counselling added to technique - but that is exactly why many of us choose to go back. The authors claim that orthodox medicine is just as 'holistic' - it could be, but it rarely is.
I would take issue with many other things in the book as well. In their campaign of reductionism they do not acknowledge that many therapies are believed to work on similar principles and use similar models. It may all be 'biologically implausible', but then why have these 'energetic' models emerged independently in several continents at many different times, and why have they become a common vocabulary for so many millions of people just as science has?
I have no doubt that the negative tales the authors tell are true, but selectivity in support of a particular polemic is nothing like the whole truth. Either I am inordinately gullible, unbelievable suggestible, or the therapies that I chose to use offer something that isn't yet easily measured by orthodox methods and means that my visits to the doctor are incredibly rare.
I may heartily disagree with much in this book, but it has at least helped me to understand how frustrating non-orthodox medicine can appear to be to those who see modern science as the final frontier. For that, and the great story-telling I thank the authors most sincerely.
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