Another little pearl from Edzard Ernst

Edzard Ernst tweets his followers that he has published an update of his systematic review of reflexology (below)

imagesIn February the professor stated in Pulse that systematic reviews" “have to include a strong element of critical evaluation of the primary studies. If, almost by definition, the primary studies can never be negative, and if they are not even accessible for independent evaluation, something is badly amiss. In such a situation the old adage applies: ‘rubbish in, rubbish out’. The danger is that, once ‘rubbish’ has been published in the form of a systematic review in a trusted journal by an international team of authors from respected institutions, it can easily be mistaken for reliable evidence. This, I believe, would be a mistake, and a dangerous one at that!

In other words when Mr Ed does a systematic review and it is negative of CAM it is a good review. A review of positive CAM studies by default must be rubbish and therefore the systematic review of positive studies would also be rubbish. Which begs the question why bother doing  studies to please this man.

Maturitas. 2011 Feb;68(2):116-20. Epub 2010 Dec 15.

Reflexology: An update of a systematic review of randomised clinical trials.

Ernst E, Posadzki P, Lee MS.

Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, 25 Victoria Park Road, Exeter EX2 4NT, UK.


Reflexology is a popular form of complementary and alternative medicine (CAM). The aim of this update is to critically evaluate the evidence for or against the effectiveness of reflexology in patients with any type of medical condition. Six electronic databases were searched to identify all relevant randomised clinical trials (RCTs). Their methodological quality was assessed independently by the two reviewers using the Jadad score. Overall, 23 studies met all inclusion criteria. They related to a wide range of medical conditions. The methodological quality of the RCTs was often poor. Nine high quality RCTs generated negative findings; and five generated positive findings. Eight RCTs suggested that reflexology is effective for the following conditions: diabetes, premenstrual syndrome, cancer patients, multiple sclerosis, symptomatic idiopathic detrusor over-activity and dementia yet important caveats remain. It is concluded that the best clinical evidence does not demonstrate convincingly reflexology to be an effective treatment for any medical condition.

Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

PMID: 21111551 [PubMed – in process

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