A new website came to my attention that promises to “Discover what truly works.” The idea is to essentially crowdsource anecdotal reports about what treatments work for specific conditions.
This is an interesting idea, that can harness the power of information flow over the internet to do what is essentially an observational, uncontrolled, and unscientific study about treatment effects. At its best, this type of information would consist of what we call a pragmatic study – an open-label study of the real-world application of specific treatments.
Pragmatic studies have their place – they add information about the practical applicability of various treatments. Pragmatic studies, however, are not efficacy trials – they cannot and should not be used to make efficacy claims. It has recently come into vogue for proponents of various CAM treatments to rely on pragmatic studies to make efficacy claims, when actual efficacy trials have failed to show effectiveness. (more…)