Which of the following are reasons Borgerson gives for thinking that the effectiveness of alternative medicine will not necessarily be demonstrated in large-scale, randomized controlled trials? (Check BOTH that apply)

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Question restatement: Identify which two reasons Borgerson gives for why the effectiveness of alternative medicine might not show up in large-scale randomized controlled trials (RCTs).

Option 1: 'RCTs are the best way to test the effectiveness of all kinds of medical interventions, but CAM therapies should be held to a different standard.' This is not aligned with Borgerson’s critique. It overstates universality of RCT suitability and implies CAM should have a unique standard, which is not the nuance he argues. In other words, this option mischaracterizes the relationship between RCTs and CAM by suggesting CAM warrants a different standard as a blanket rule, rather than highlighting specific methodological mismatches.

Option 2: 'RCTs use a control group in order to test the efficacy of a treatment against, among other things, the regression towards the mean. CAM therapies harness the natural course of the disease.' While RCT controls do guard against regression to the mean, Borgerson’s central points about CAM emphasize issues like blinding and individualization. This statement combines true-sounding elements in a way that does not capture his primary objections about why large trials may fail to detect CAM effectiveness. It also frames CAM as simply harnessing natural history, which is an oversimplification of the critique.

Option 3: 'RCTs often test interventions which are easily blinded, whereas CAM therapies are often the types of interventions which are not easily blinded.' This option reflects a core methodological mismatch highlighted by Borgerson: many CAM modalities (e.g., personalized, practitioner-delivered, or complex interventions) resist blinding, which undermines placebo-control assumptions and can obscure true effects in standard RCT designs. This is a valid reason he cites.

Option 4: 'RCTs tend to gloss over individual differences, for example, by employing strict inclusion and exclusion criteria. CAM therapies are highly individualized.' This captures another major point: RCTs often impose uniform criteria that strip away meaningful individual variation, while CAM approaches are typically tailored to the individual. This difference can lead to underestimating CAM effectiveness in large, standardized trials.

In summary, options 3 and 4 align with Borgerson’s criticisms regarding why RCTs might fail to demonstrate CAM effectiveness, due to blinding challenges and the tendency to mask individual differences, whereas options 1 and 2 do not accurately reflect his specific arguments.

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Which of the following are reasons Borgerson gives for thinking that the effectiveness of alternative medicine will not necessarily be demonstrated in large-scale, randomized controlled trials? (Check BOTH that apply)

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