The gold standard of “evidence based medicine” is the placebo controlled trial.
There are three problems with this evidence.
Was the placebo mentioned in the trial? Any trial failing to specify the placebo would be invalid – it could be around 90% of trials.
Another troubling aspect of placebos is the “placebo washout”. All intended participants are given the placebo and responders eliminated from the trial prior to its commencement. This may have occurred with a majority of trials.
If a viable alternative is known about, was this included in the trial?
A medicine is used because its efficacy is “proven by evidence”. However many natural substances are excluded and we are told “there is no evidence for their benefit”. How would well known and proven alternatives have compared if they were in the trial?
A vast and effective range of natural remedies is available – most have ample empirical evidence. That is, proven by observation and experience.
After all, this is how surgery is validated and accepted…
Many people are on multiple medications – this combination is the “treatment”.
If this combination or “treatment” hasn’t been trialed on this condition it has no scientific evidence to support it. Regardless of evidence for the medications individually.
If a person is on 5 or more medicines the clinical outcome of each of those medicines becomes entirely unpredictable.