How much medicine is evidence-based?

A few weeks ago we noticed a claim in GEO, a German magazine, stating that only 40% of medicine were evidence-based. Since the article contained lots of errors (we blogged about its flaws) and no real source was given (apart from the allegation this was a quote from a former president of State Chambers of Physicians), we were inclined to dismiss the contention without further consideration.

But then we pondered the question and started digging. We found an official document on Evidence-Based Medicine and we discovered a website of the British Medical Journal dedicated to evidence based medicine supporting the claim.

The BMJ Site displays a nice diagram showing that 51% of medicine were of unknown effectiveness! 51%. And another 15 percent were harmful/likely ineffective. We were flabbergasted. According to these figures, medicine(about 40% proven efficiacy) was not much better than alternative medicine(about 0% proven efficiacy).

A rate of unknown effectiveness of as much as 51% for medicine? Wow. We were stunned and decided to ask Professor Edzard Ernst about the BMJ page.

You probably know the following page: http://clinicalevidence.bmj.com/ceweb/about/knowledge.jsp
This overview isn’t exactly much to write home about. What is your opinion on this?
Isn’t it unfair to look down upon alternative methods when there is still so much unknown in medicine?

• Firstly, the low percentage of proven treatments is partly due to the fact that this figure includes alternative medicine.
• Secondly, the figure relates to all treatments even those that are very rarely used. If you look at the percentage of effective treatments that are actually in daily use, you arrive at figures around 80%.
• Thirdly the process of applying science to medicine is relatively young – so we are looking at work in progress.
• Fourthly, if one area is not optimal, this is no reason to allow another one to be even worse.

Alternative medicine is included in those figures? Well, ok, that explains a lot.

“By definition”, I begin
“Alternative Medicine”, I continue
“Has either not been proved to work,
Or been proved not to work.
You know what they call “alternative medicine”
That’s been proved to work?
Medicine.”

(Storm by Tim Minchin)