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May 1999

Randomized Trials and Scientific Methods

Author Affiliations

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Arch Dermatol. 1999;135(5):602. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-5-dlt0599

We enjoyed the article by Smolle et al1 that discussed a randomized clinical trial of homeopathy for warts. We strongly agree with the statement in their introduction that ". . . scientific methods are valuable tools for distinguishing helpful alternative medical methods from superstition and quackery."

Scientific methods do not necessarily require a randomized trial. We can argue that sometimes a randomized trial is harmful. When a trial is performed, a test of statistical significance is done, such as a t test. The standard in clinical medicine for a statistically significant result is a P value less than or equal to .05. Accepting a P value of .05 means that there is a 1 in 20 chance that a therapy without merit could be shown to be significant. One way to decrease the likelihood of getting a spurious result is to limit trials to topics that have a potentially medically explainable result. Is there even 1 scientifically defensible hypothesis for the therapeutic basis of homeopathy? Have any basic science experiments ever shown that the chemically pure water used in homeopathy is different from normal water?

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