European Journal of Internal Medicine 26 (2015) e6
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European Journal of Internal Medicine journal homepage: www.elsevier.com/locate/ejim
Letter to the Editor Logical reasoning alone is often not enough
We do not doubt that “Millions of patients experience an effect of CAM, often after conventional medicine failed”, as Rutten and Stolper say [1]. The question, as our paper maintains [2], is whether this improvement is due to the specific efficacy of the intervention or to other causes like placebo effect and/or spontaneous regression of the disease. And this crucial question cannot be answered without the help of a meaningful inferential statistics. We are impressed by the example showing how rapidly a very low prior probability evolves into a highly significant posterior one following consecutive positive experiments. However, in order to be clinically conclusive, trials of this type, besides being consecutive, should be independently repeated. As far as we know, no such evidence is available for any CAM intervention. Surely, as Rutten and Stolper say, “…statistics, Bayesian or frequentist, cannot replace logical reasoning”. But sound statistics is still needed to draw conclusions and take necessary decisions.
References [1] Rutten L, Stolper E. Complementary alternative medicine (CAM), plausibility and statistics. Eur J Intern Med 2014;26:e5. [2] Pandolfi M, Carreras G. The faulty statistics of complementary alternative medicine (CAM). Eur J Intern Med 2014;25:607–9.
Maurizio Pandolfi University of Lund, Sweden Corresponding author at: Via de' Martelli 7, 50129 Florence, Italy. Tel.: +39 055283943. E-mail addresses: mauri.pandolfi@gmail.com.
http://dx.doi.org/10.1016/j.ejim.2014.09.005 0953-6205/© 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Giulia Carreras Cancer Prevention and Research Institute (ISPO), via delle Oblate 2, 50139 Florence, Italy 23 July 2014
Contents lists available at ScienceDirect
European Journal of Internal Medicine journal homepage: www.elsevier.com/locate/ejim
Letter to the Editor Logical reasoning alone is often not enough
We do not doubt that “Millions of patients experience an effect of CAM, often after conventional medicine failed”, as Rutten and Stolper say [1]. The question, as our paper maintains [2], is whether this improvement is due to the specific efficacy of the intervention or to other causes like placebo effect and/or spontaneous regression of the disease. And this crucial question cannot be answered without the help of a meaningful inferential statistics. We are impressed by the example showing how rapidly a very low prior probability evolves into a highly significant posterior one following consecutive positive experiments. However, in order to be clinically conclusive, trials of this type, besides being consecutive, should be independently repeated. As far as we know, no such evidence is available for any CAM intervention. Surely, as Rutten and Stolper say, “…statistics, Bayesian or frequentist, cannot replace logical reasoning”. But sound statistics is still needed to draw conclusions and take necessary decisions.
References [1] Rutten L, Stolper E. Complementary alternative medicine (CAM), plausibility and statistics. Eur J Intern Med 2014;26:e5. [2] Pandolfi M, Carreras G. The faulty statistics of complementary alternative medicine (CAM). Eur J Intern Med 2014;25:607–9.
Maurizio Pandolfi University of Lund, Sweden Corresponding author at: Via de' Martelli 7, 50129 Florence, Italy. Tel.: +39 055283943. E-mail addresses: mauri.pandolfi@gmail.com.
http://dx.doi.org/10.1016/j.ejim.2014.09.005 0953-6205/© 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Giulia Carreras Cancer Prevention and Research Institute (ISPO), via delle Oblate 2, 50139 Florence, Italy 23 July 2014
