What’s the most cited academic paper on complementary and alternative medicine (CAM)? Is it an evidence-based trial demonstrating the efficacy of a particular therapy? Is it a systematic review of a collection of efficacy literature? Is it a paper that explains a single major CAM modality, such as acupuncture or chiropractic, or one that explains them all? Or is it a treatise on how biological mechanisms (such as the placebo effect) can help explain how such therapies appear to work? Actually, it’s none of these. The most cited CAM paper in history doesn’t tell us how CAM works, how effective it is, what its limitations might be, or even what it actually comprises – instead, it tells us how popular CAM is. Yes, that, and how much it costs. In other words, it’s a paper about the marketing and commercial dimensions of the CAM industry in the US. And it appears in one of the most widely read medical journals in the world.
Now you might expect that a heavily cited paper must be a terrific one to consult, given that so many wise academics have found it to be such a useful source. For example, its methodology and conclusions must be pretty robust, and its take-home message impressively reliable, right? Right? Well, no, not really. Despite the fact that its findings are regularly cited, they are so wholly unreliable as to be highly ambiguous, if not downright misleading. The reason it gets cited so much has little to do with academic rigour or scientific validity. It gets cited because it makes the right point from a partisan perspective: namely, that CAM is just so hugely popular that everybody is using it! Continue reading




























