Edzard Ernst
Encyclopedia
Edzard Ernst is the first Professor of Complementary Medicine
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....

 in the world, at the University of Exeter
University of Exeter
The University of Exeter is a public university in South West England. It belongs to the 1994 Group, an association of 19 of the United Kingdom's smaller research-intensive universities....

, England.

In 1993, Ernst left his chair in Physical Medicine and Rehabilitation
Physical medicine and rehabilitation
Physical medicine and rehabilitation , physiatry or rehabilitation medicine, is a branch of medicine that aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. A physician having completed training in this field is referred to as a...

 (PMR) at the University of Vienna
University of Vienna
The University of Vienna is a public university located in Vienna, Austria. It was founded by Duke Rudolph IV in 1365 and is the oldest university in the German-speaking world...

 to set up the department of Complementary Medicine at the University of Exeter
University of Exeter
The University of Exeter is a public university in South West England. It belongs to the 1994 Group, an association of 19 of the United Kingdom's smaller research-intensive universities....

. He became director of complementary medicine of the Peninsula Medical School (PMS) in 2002. He was the first occupant of the Laing
Maurice Laing
Sir John Maurice Laing was a senior executive of British construction company John Laing plc. He was the first president of the Confederation of British Industry in 1965-6....

 chair in Complementary Medicine, retiring in 2011. He was born and trained in Germany — Ernst began his medical career at a homeopathic hospital in Munich
Munich
Munich The city's motto is "" . Before 2006, it was "Weltstadt mit Herz" . Its native name, , is derived from the Old High German Munichen, meaning "by the monks' place". The city's name derives from the monks of the Benedictine order who founded the city; hence the monk depicted on the city's coat...

 — and since 1999 has been a British citizen.

Ernst is the editor-in-chief of two medical journal
Medical journal
A public health journal is a scientific journal devoted to the field of public health, including epidemiology, biostatistics, and health care . Public health journals, like most scientific journals, are peer-reviewed...

s, Perfusion and Focus on Alternative and Complementary Therapies. Ernst once contributed a regular column to The Guardian
The Guardian
The Guardian, formerly known as The Manchester Guardian , is a British national daily newspaper in the Berliner format...

newspaper, frequently reviewing news stories about complementary medicine from an evidence-based medicine
Evidence-based medicine
Evidence-based medicine or evidence-based practice aims to apply the best available evidence gained from the scientific method to clinical decision making. It seeks to assess the strength of evidence of the risks and benefits of treatments and diagnostic tests...

 perspective.

Since his research began on alternative modalities, Ernst has become "the scourge of alternative medicine" for publishing critical research that exposes methods that lack documentation of efficacy.

Training and early career

Ernst qualified as a physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

 in Germany in 1978 where he also completed his M.D. and Ph.D.
Ph.D.
A Ph.D. is a Doctor of Philosophy, an academic degree.Ph.D. may also refer to:* Ph.D. , a 1980s British group*Piled Higher and Deeper, a web comic strip*PhD: Phantasy Degree, a Korean comic series* PhD Docbook renderer, an XML renderer...

 theses. He has received some training in acupuncture
Acupuncture
Acupuncture is a type of alternative medicine that treats patients by insertion and manipulation of solid, generally thin needles in the body....

, autogenic training
Autogenic training
Autogenic training is a relaxation technique developed by the German psychiatrist Johannes Heinrich Schultz and first published in 1932. The technique involves the daily practice of sessions that last around 15 minutes, usually in the morning, at lunch time, and in the evening. During each session,...

, herbalism
Herbalism
Herbalism is a traditional medicinal or folk medicine practice based on the use of plants and plant extracts. Herbalism is also known as botanical medicine, medical herbalism, herbal medicine, herbology, herblore, and phytotherapy...

, homoeopathy, massage therapy and spinal manipulation
Spinal manipulation
Spinal manipulation is a therapeutic intervention performed on spinal articulations which are synovial joints . These articulations in the spine that are amenable to spinal manipulative therapy include the z-joints, the atlanto-occipital, atlanto-axial, lumbosacral, sacroiliac, costotransverse...

. but never formally registered as a homeopath. Ernst began his medical career at a homeopathic hospital in Munich
Munich
Munich The city's motto is "" . Before 2006, it was "Weltstadt mit Herz" . Its native name, , is derived from the Old High German Munichen, meaning "by the monks' place". The city's name derives from the monks of the Benedictine order who founded the city; hence the monk depicted on the city's coat...

. In 1988, he became Professor in Physical Medicine and Rehabilitation (PMR) at Hannover Medical School
Hannover Medical School
The Hannover Medical School , founded in 1965, is a university medical centre in Germany, part of a regional medical network.-International:...

 and in 1990 Head of the PMR Department at the University of Vienna.

Work in complementary medicine

The world's first professor of complementary medicine, Ernst researches complementary medicine with an emphasis on efficacy and safety. His research mainly surveys systematic reviews and meta-analyses of clinical trial
Clinical trial
Clinical trials are a set of procedures in medical research and drug development that are conducted to allow safety and efficacy data to be collected for health interventions...

s; the institute has not performed a clinical trial for some time due to budget constraints. He has over 700 papers published in scientific journals. He has said that about 5 percent of alternative medicine
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....

 is backed by evidence, with the remainder being either insufficiently studied or backed by evidence showing lack of efficacy.

Ernst's department at Exeter defines complementary medicine as "diagnosis, treatment and/or prevention which complements mainstream medicine by contributing to a common whole, by satisfying a demand not met by orthodoxy or by diversifying the conceptual frameworks of medicine."

Ernst asserts that, in Germany and Austria, complementary techniques are mostly practiced by qualified physicians, whereas in the UK they are mainly practiced by others. Ernst also argues that the term "Complementary and Alternative Medicine" ("CAM") is an almost nonsensical umbrella term, and that distinctions between its modalities must be made.

Since his research began on alternative modalities, Ernst, who is himself a former homeopathic
Homeopathy
Homeopathy is a form of alternative medicine in which practitioners claim to treat patients using highly diluted preparations that are believed to cause healthy people to exhibit symptoms that are similar to those exhibited by the patient...

 practitioner, has become "the scourge of alternative medicine" for publishing critical research. In a 2008 publication in the British Journal of General Practice, Ernst's listed treatments that "demonstrably generate more good than harm" was limited to St John's wort
St John's wort
St John's wort is the plant species Hypericum perforatum, and is also known as Tipton's Weed, Chase-devil, or Klamath weed....

 for depression
Clinical depression
Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...

; hawthorn for congestive heart failure
Congestive heart failure
Heart failure often called congestive heart failure is generally defined as the inability of the heart to supply sufficient blood flow to meet the needs of the body. Heart failure can cause a number of symptoms including shortness of breath, leg swelling, and exercise intolerance. The condition...

; guar gum
Guar gum
Guar gum, also called guaran, is a galactomannan. It is primarily the ground endosperm of guar beans. The guar seeds are dehusked, milled and screened to obtain the guar gum. It is typically produced as a free-flowing, pale, off-white-colored, coarse to fine ground powder.-Production:Guar gum is an...

 for diabetes; acupuncture
Acupuncture
Acupuncture is a type of alternative medicine that treats patients by insertion and manipulation of solid, generally thin needles in the body....

 for nausea
Nausea
Nausea , is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting...

 and osteoarthritis
Osteoarthritis
Osteoarthritis also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion...

; aromatherapy
Aromatherapy
Aromatherapy is a form of alternative medicine that uses volatile plant materials, known as essential oils, and other aromatic compounds for the purpose of altering a person's mind, mood, cognitive function or health....

 as a palliative treatment for cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

; hypnosis
Hypnosis
Hypnosis is "a trance state characterized by extreme suggestibility, relaxation and heightened imagination."It is a mental state or imaginative role-enactment . It is usually induced by a procedure known as a hypnotic induction, which is commonly composed of a long series of preliminary...

 for labour pain; and massage, music therapy
Music therapy
Music therapy is an allied health profession and one of the expressive therapies, consisting of an interpersonal process in which a trained music therapist uses music and all of its facets—physical, emotional, mental, social, aesthetic, and spiritual—to help clients to improve or maintain their...

, and relaxation therapy for anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...

 and insomnia
Insomnia
Insomnia is most often defined by an individual's report of sleeping difficulties. While the term is sometimes used in sleep literature to describe a disorder demonstrated by polysomnographic evidence of disturbed sleep, insomnia is often defined as a positive response to either of two questions:...

.

Smallwood Report

In 2005, a report by economist Christopher Smallwood, personally commissioned by Prince Charles, claimed that CAM was cost-effective and should be available in the National Health Service
National Health Service (England)
The National Health Service or NHS is the publicly funded healthcare system in England. It is both the largest and oldest single-payer healthcare system in the world. It is able to function in the way that it does because it is primarily funded through the general taxation system, similar to how...

 (NHS). Ernst was initially enlisted as a collaborator on the report, but asked for his name to be removed after a sight of the draft report convinced him that Smallwood had "written the conclusions before looking at the evidence". The report did not address whether CAM treatments were actually effective and Ernst described it as "complete misleading rubbish."

Ernst was, in turn, criticised by The Lancet
The Lancet
The Lancet is a weekly peer-reviewed general medical journal. It is one of the world's best known, oldest, and most respected general medical journals...

editor Richard Horton
Richard Horton
Richard Horton, FRCP FMedSci, is the present editor-in-chief of The Lancet, a United Kingdom-based medical journal.-Education and career:...

 for disclosing contents of the report while it was still in draft form. In a letter to The Times
The Times
The Times is a British daily national newspaper, first published in London in 1785 under the title The Daily Universal Register . The Times and its sister paper The Sunday Times are published by Times Newspapers Limited, a subsidiary since 1981 of News International...

Horton wrote: "Professor Ernst seems to have broken every professional code of scientific behaviour by disclosing correspondence referring to a document that is in the process of being reviewed and revised prior to publication. This breach of confidence is to be deplored."

Prince Charles' private secretary, Sir Michael Peat, also filed a complaint regarding breached confidentiality with Exeter University. Ernst has claimed that circumstances surrounding the ensuing University investigation led to his retirement.

Trick or Treatment

In 2008, Ernst and Simon Singh
Simon Singh
Simon Lehna Singh, MBE is a British author who has specialised in writing about mathematical and scientific topics in an accessible manner....

 published Trick or Treatment? Alternative Medicine on Trial
Trick or Treatment
Trick or Treatment? Alternative Medicine on Trial is a 2008 book about alternative medicine by Simon Singh and Edzard Ernst. Singh is a physicist and the writer of several popular science books...

. The authors challenged the Prince of Wales, to whom the book is (ironically) dedicated, and the Foundation for Integrated Health on alleged misrepresentation of "scientific evidence about therapies such as homoeopathy, acupuncture and reflexology". Singh and Ernst assert that Britain spends £500 million each year on unproven or disproven alternative therapies. In a review of Trick or Treatment in the New England Journal of Medicine
New England Journal of Medicine
The New England Journal of Medicine is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It describes itself as the oldest continuously published medical journal in the world.-History:...

, Donald Marcus described Ernst as "one of the best qualified people to summarize the evidence on this topic."

In 2008, Ernst sent an open letter urging the Royal Pharmaceutical Society of Great Britain
Royal Pharmaceutical Society of Great Britain
The Royal Pharmaceutical Society of Great Britain was formerly the statutory regulatory and professional body for pharmacists and pharmacy technicians in England, Scotland and Wales...

 to crack down on high street chemists that sell homeopathic remedies without warning that the remedies lack evidence for claimed biological effects. According to Ernst, this disinformation would be a violation of their ethical code:
My plea is simply for honesty. Let people buy what they want, but tell them the truth about what they are buying. These treatments are biologically implausible and the clinical tests have shown they don't do anything at all in human beings. The argument that this information is not relevant or important for customers is quite simply ridiculous.


In a 2008 interview with Media Life Magazine
Media Life Magazine
Media Life Magazine is an online daily magazine/newspaper that started in May 1999 by Gene Ely. The publication covers all aspects of the media.-External links:* at LinkedIn...

, when Ernst and Simon Singh were asked this question -- "What do you think the future is for alternative medicine?" -- they replied:
For us, there is no such thing as alternative medicine. There is either medicine that is effective or not, medicine that is safe or not. So-called alternative therapies need to be assessed and then classified as good medicines or bogus medicines. Hopefully, in the future, the good medicines will be embraced within conventional medicine and the bogus medicines will be abandoned.


In an article entitled "Should We Maintain an Open Mind about Homeopathy?" published in the American Journal of Medicine
American Journal of Medicine
The American Journal of Medicine is the official medical journal of the Association of Professors of Medicine, publishing original clinical research in internal medicine of interest to physicians in academia and in community based practice...

, Michael Baum
Michael Baum
Professor Michael Baum, Professor Emeritus of Surgery and visiting Professor of Medical Humanities at University College London , is a leading British oncologist who specialises in breast cancer treatment. He is also notable for his contributions to the evaluation and support of patient quality of...

 and Edzard Ernst—writing to other physicians—wrote some strong criticisms of homeopathy:
Homeopathy is among the worst examples of faith-based medicine... These axioms [of homeopathy] are not only out of line with scientific facts but also directly opposed to them. If homeopathy is correct, much of physics, chemistry, and pharmacology must be incorrect.... To have an open mind about homeopathy or similarly implausible forms of alternative medicine (eg, Bach flower remedies
Bach flower remedies
Bach flower remedies are dilutions of flower material developed by Edward Bach, an English bacteriologist, pathologist and homeopath, in the 1930s. Bach believed that dew found on flower petals retain healing properties of that plant...

, spiritual healing, crystal therapy) is therefore not an option. We think that a belief in homeopathy exceeds the tolerance of an open mind. We should start from the premise that homeopathy cannot work and that positive evidence reflects publication bias or design flaws until proved otherwise... We wonder whether any kind of evidence would persuade homeopathic physicians of their self-delusion and challenge them to design a methodologically sound trial, which if negative would finally persuade them to shut up shop... Homeopathy is based on an absurd concept that denies progress in physics and chemistry. Some 160 years after Homeopathy and Its Kindred Delusions, an essay by Oliver Wendell Holmes, we are still debating whether homeopathy is a placebo or not... Homeopathic principles are bold conjectures. There has been no spectacular corroboration of any of its founding principles... After more than 200 years, we are still waiting for homeopathy "heretics" to be proved right, during which time the advances in our understanding of disease, progress in therapeutics and surgery, and prolongation of the length and quality of life by so-called allopaths have been breathtaking. The true skeptic therefore takes pride in closed mindedness when presented with absurd assertions that contravene the laws of thermodynamics or deny progress in all branches of physics, chemistry, physiology, and medicine.

Early retirement from Exeter

Ernst was accused by Prince Charles' private secretary of having breached a confidentiality agreement regarding the 2005 Smallwood report. After being subjected to a "very unpleasant" investigation by the University of Exeter
University of Exeter
The University of Exeter is a public university in South West England. It belongs to the 1994 Group, an association of 19 of the United Kingdom's smaller research-intensive universities....

, in which he was "treated as guilty until proven innocent", the university accepted his innocence but continued, in his view, to treat him as "persona non grata". All fundraising for his unit ceased, forcing him to use up its core funding and allow its 15 staff to drift away. Ernst retired in 2011, two years ahead of his official retirement.

Other work

In a May 1995 Annals of Internal Medicine
Annals of Internal Medicine
Annals of Internal Medicine is an academic medical journal published by the American College of Physicians . It publishes research articles and reviews in the area of internal medicine. Its current editor is Christine Laine...

publication, Ernst detailed the Nazi "cleansing" of the University of Vienna medical faculty that allowed the "medical atrocities" of Nazi human experimentation
Nazi human experimentation
Nazi human experimentation was a series of medical experiments on large numbers of prisoners by the Nazi German regime in its concentration camps mainly in the early 1940s, during World War II and the Holocaust. Prisoners were coerced into participating: they did not willingly volunteer and there...

.

Other significant posts

Ernst is a member of the Medicines Commission of the British Medicines Control Agency (now part of the MHRA) which determines which substances may be introduced and promoted as medicine. He also sits on the Scientific Committee on Herbal Medicinal Products of the Irish Medicines Board. He is an external examiner for several university medical schools in several countries. Ernst is a Founding Member and on the Board of the Institute for Science in Medicine, formed in 2009.

In February 2011 Ernst was elected as a Fellow of the Committee for Skeptical Inquiry

Criticisms

Chiropractors Joseph Morley and Daniel Redwood, along with Anthony L. Rosner of the Foundation for Chiropractic Education and Research, criticized Ernst's work, describing publications on chiropractic by Ernst et al. as including "repeated misuse of references, misleading statements, highly selective use of certain published papers, failure to refer to relevant literature, inaccurate reporting of the contents of published work, and errors in citation".

In 2011, Andrew Vickers, a research methodologist at Memorial Sloan-Kettering Cancer Center
Memorial Sloan-Kettering Cancer Center
Memorial Sloan–Kettering Cancer Center is a cancer treatment and research institution founded in 1884 as the New York Cancer Hospital...

, wrote an editorial opinion criticising and citing a number of systematic review
Systematic review
A systematic review is a literature review focused on a research question that tries to identify, appraise, select and synthesize all high quality research evidence relevant to that question. Systematic reviews of high-quality randomized controlled trials are crucial to evidence-based medicine...

s co-authored by Ernst for 'reducing review to a cut and paste' of 'empty scientific exercises' that 'make the re-viewer appear scientifically productive, but they do little to further science, or help relieve human suffering.'

Books

  • Healing, Hype, Or Harm?: Scientists Investigate Complementary Or Alternative Medicine (ed.) Imprint Academic 2008, ISBN 9781845401184, 120 pages
  • Trick or Treatment? Alternative Medicine on Trial (with Simon Singh
    Simon Singh
    Simon Lehna Singh, MBE is a British author who has specialised in writing about mathematical and scientific topics in an accessible manner....

    ). Transworld Publisher 2008. ISBN 978-0-59-30612-99 (The same book published in the USA is called Trick or Treatment: The Undeniable Facts about Alternative Medicine).
  • The Oxford Handbook of Complementary Medicine. Oxford University Press 2008. ISBN 978-0-19-920677-3
  • Complementary Therapies for Pain Management. An Evidence-Based Approach. Elsevier Science 2007. ISBN 978-0-7234-3400-9
  • The Desktop Guide to Complementary and Alternative Medicine: An Evidence-based Approach. Elsevier Health Sciences 2006, ISBN 9780723433835, 556 pages
  • Homoeopathy: A Critical Appraisal (with Eckhart G. Hahn). Butterworth-Heinemann 1998. ISBN 0-7506-3564-9

External links

The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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