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Commentary |

On Equivalence Trials and Alternative Medicine

Bevan Yueh, MD, MPH; Jay F. Piccirillo, MD
Arch Otolaryngol Head Neck Surg. 2003;129(4):403-404. doi:10.1001/archotol.129.4.403.
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THIS ISSUE of the ARCHIVES includes a letter1 critical of a 1998 article in this journal on a homeopathic treatment for vertigo.2 The author of the letter, Dr Wallace Sampson, raises important issues about standards for critically evaluating new treatment, regardless of whether these interventions lie in the domain of allopathic or alternative medicine.

In the original article, Weiser et al2 reported on a randomized equivalence trial comparing the efficacy of a homeopathic treatment ("Vertigoheel") with what they claimed was an active control agent (betahistine hydrochloride). In this double-blind trial involving 105 analyzable patients, they found statistically similar reductions in the frequency, duration, and intensity of vertigo attacks in both treatment arms. The authors argued that because betahistine (known in the United States as Serc) had previously demonstrated efficacy and was "standard treatment for patients experiencing vertigo," their demonstration of equivalence suggested that Vertigoheel was efficacious as well.

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