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on 30 May 2014
I found the treatment very scientific. It changed my opinion about accupuncture. I have had it done a few times as my osteopath recommended it for faster recovery. In retrospect, the recovery was no different. Thouroughly recommended.
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on 5 June 2013
I've recommended this book to all my friends - and indeed bought it for some of them too !

Really intelligent & well-written analysis of what really goes on, and a book that can be referred-back-to over & over.

Highly recommended, and utterly woo-free !
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on 27 March 2014
I bought read and highlighted key parts for my grandmother who is a believer in homeopathy as opposed to the placebo effect and power of mental conviction. Well explained, clearly laid out and with summary and review of the most common homeopathic 'medicines'.
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on 31 May 2011
This should be essential reading alongside Ben Goldacre's Bad Science. Both books serve a vitally important role. Where Goldacre's book is a little more chatty, it's author being the 'David Brent' of the popular science writers world (I'm cool, you'd love to have a drink with me, and yeah, I can drink loads, while leading two double-blind trials, writing newspaper columns, participating in amateur dramatics (yes, really!) and being the funniest guy you've ever met... I'm cool, I swear, particularly if it impresses the kids and ...), Ernst and Singh's book is a little more sober, the authors being less desperate to impress. The books compliment each other well. If you come away, as some readers have, unconvinced,claiming the authors to be part of some conspiracy, or accusing them of blind prejudice against CAM then you have simply failed to understand the basic points they're making, and those points are not difficult to understand. This book and Goldacre's explain with admirable clarity the placebo effect and the way a double blind trial works and why they're important. Not difficult notions to understand in any case, but, just in case, here they are explained clearly, so all can grasp them. All treatments should undergo rigorous testing, much of the stuff on your health food shops' shelves hasn't, and when it has it has been shown (with very very few exceptions)to have all the healing qualities of a sugar pill, which in the case of homeopathy isn't surprising since that's what they generally are.
Now, to the KINDLE edition. 1 month into my Kindle ownership and I'm now getting pretty irritated by the shoddy quality of many of the Kindle editions. This one leaves block quotes (long quotes that are set out separate from the text in the print edition) in the same font, without quotation marks and with the same paragraph indentation as the main text; so often you find yourself half way through a quotation before realising that you are reading a quotation, and then you have to workout where it ends and the main text recommences. In addition, some special symbols just come out peculiar, as do some of the lists. Is it too difficult to make the Kindle editions the same quality as the print editions? This should not even be a question. This is really poor and shows disrespect for those who have bought Kindles. C'mon Amazon!
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VINE VOICEon 22 December 2012
Trick or Treatment is a very interesting read about the evidence that exists for the effectiveness (or not) of various complementary and alternative therapies (CAM). The book focuses especially on acupuncture, homeopathy, chiropractic and herbal medicine, with an appendix covering many more treatments in brief. I enjoyed reading the anecdotes on the history of CAM and conventional medicine, and there was a lot of useful information in there, but the authors' tone and approach left me questioning whether they were as unbiased as they claimed to be. Incidentally, I'm a big believer in the principles of evidence-based medicine (EBM), and I'm sceptical about many alternative therapies, so I didn't expect to have a problem with this book.

The main reasons I found myself distrusting Singh and Ernst are as follows:

1. Trick or Treatment claims to be a neutral presentation of the facts, but it is written in a very persuasive tone, with disparaging language used for anything the authors disapprove of. I really felt they were giving me the 'hard sell', which seems at odds with the concept of EBM. Much is made of the fact that Ernst used to be a homeopath, which supposedly makes him less biased, but to me the book seemed to have been written by someone who had become disillusioned by his former profession and therefore had strong feelings about it. On its own, this is not necessarily a problem, but in comparison with the points below it made me wary.

2. Throughout the book, the authors imply that modern conventional medicine is always better than CAM and that it always it has better evidence. They do not acknowledge any of the problems with research in conventional medicine, such as publication bias, or the fact that poor-quality trials exist here too. Anecdotal evidence for the effectiveness of CAM treatments is rightly dismissed as unreliable, but then they present anecdotal evidence in support of conventional medicine or to 'demonstrate' the risks of alternative therapies.

For example, they describe the case of a woman with mental health problems who killed her children after switching from the psychiatric drug Tegretol to St John's wort. This is a devastating tragedy and of course questions should be asked about whether the herb could have been responsible. However, it is wrong of the authors to state unequivocally that being 'deprived' of her usual medication and adverse effects from the St John's wort were the cause. We simply cannot know this, which is why scientific studies are needed. It could equally be that Charlene Dorcy's mental health was already deteriorating and that was what motivated her to change her treatment - it is so hard to tell from one individual case. Similar tragic cases have in fact occurred on conventional antidepressants such as Prozac, but the authors do not mention this.

3. The authors position themselves as experts, rather than presenting the facts and allowing readers to make up their own minds. For me, this contrasted sharply with Ben Goldacre's Bad Science (a book I love). Goldacre frequently provides details of clinical trials and other studies and encourages readers to look at them for themselves; he is also outspoken about the dangers of looking to so-called experts for information rather than examining the evidence. Singh and Ernst tell the reader what to believe, give advice on which type of treatment to seek, and the vast majority of the facts they cite are not referenced, so there is no way of checking them. I was, for example, surprised to read that evidence suggests meditation is dangerous for those with mental illness and therefore should be avoided by this group of patients. Given that one in four of us experience mental ill health, and mental health problems are a very common reason for people to try meditation, I wanted to know more about how the authors define 'mental illness' and what the specific evidence is. But as no details of trials or sources are provided, it will be difficult for me to do that.

If you'd like an overview of the evidence for CAM, peppered with interesting anecdotes, then Trick or Treatment is definitely worth a read. However, if you consider yourself intelligent and capable of drawing your own conclusions, you may find the tone and the amount of repetition a little patronising. It can also be quite difficult to find the information on specific treatments for specific problems, because not only do your have to sift through all the rhetoric, the book's structure is somewhat confusing, with information on the risks of acupuncture and homeopathy in the chiropractic chapter, for example.

This probably reads like a very harsh review. In fairness to the authors, I agree with much of what they're saying (in terms of content) and I don't seriously doubt most of the facts they've presented. But I feel Singh and Ernst failed to show the scrupulous fairness that a book on evidence-based medicine demands. Knowing whether complementary and alternative therapies are safe and effective is such an important issue, and I am disappointed they did not tackle it in a more even-handed way.
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on 9 November 2014
Great book by Singh & Ernst. Sadly, it will probably have limited impact on the woo-merchants and quacks who dispense such alternative remedies, either because they are making a good living out of selling ineffective products or, worse, they actually believe their own hype.
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TOP 500 REVIEWERon 15 August 2014
This book takes an objective look at alternative medicine. The outcome is electrifying to everyone who thinks and has used or considered using anything like homeopathy or acupuncture. Singh and Ernst don’t set out with any malice – Ernst has worked for many years in alternative medicine – but they show devastatingly how proper trials have shown these alternative treatments to rarely be better than a placebo, and often to have negative or even life-threatening consequences.

It really is striking – the vast majority of alternative medical treatments are proved to be on a par with snake oil. Apart from anything else, this ought to be required reading for doctors -a surprising number encourage alternative treatment – for celebrities who endorse this kind of medication and particularly the media which all too often is wide-eyed and idiotic on the subject of alternative treatments. In the UK, Prince Charles who has bumbled on about the subject for many years, ought to be forced to copy this book out by hand until he gets the point.

All in all, a really important book which wasn't given the coverage it deserved when it came out, and what’s more it’s very readable too. By combining Ernst’s expertise on the subject and Singh’s superb science writing we have a book that is as entertaining as it is informative, and the emphasis on real testing will be a delight to anyone who enjoys the saying ‘data is not the plural of anecdote.’ More than recommended – essential.
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on 13 January 2014
It was the author rather than the subject which drew me to this book: having previously read "The Code Book", "Fermat's Last Theorem" and "Big Bang", I think Mr. Singh is brilliant at putting across sometimes complex ideas concisely and with clarity. Once again, he does not disappoint. The book is beautifully written, and entertains as much as it informs. Roll on the next book by SImon - whatever the subject!
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on 22 February 2014
Informative and a good read. Sensible and logical and now feel more informed and happy to ignore friends who think alternative medicine a good thing.
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on 14 July 2012
This is one of the books in a growing movement that is fighting for all that we gained in the Enlightenment, and which in the late twentieth and early twenty first century appears to be slipping away in a cloud of wishful, hazy thinking.

The key is evidence-based medicine. In other words, not wanting or hoping or idly believing a treatment will work, but testing if it is so. There is nothing sinister or 'un-holistic' about a trial - it merely tests if something works against a control or placebo. When most complementary therapies are tested this way, the evidence, for them, is devastating.

This books clearly explains the history of medicine before the evidence-based approach. One word : scary. It explains how trials work and it then tests alternative medicines. It also shows how practitioners try to squirm their way out of begin tested, argued with and ultimately exposed.

An excellent book. I think, however, Ben Goldacre's Bad Science wins over for prose style and entertainment factor, while also being hugely informative.
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