This is a common straw man attack, that randomized controlled trials are the only valid form of scientific evidence. Oddly enough, that is EXACTLY what proponents of science-based medicine argue against, just not in the way our friend here thinks. I'll briefly explain. 1/
I've used a term, "methodolatry," to describe the "obscene worship of the double blind RCT as the only valid method of scientific investigation," and some extreme EBM proponents do occasionally exhibit this quality. They are the minority, however. 2/
We all know that sometimes double blind RCTs can't be done for various reasons. Some RCTs would be unethical; for instance, using a placebo is usually unethical if an effective therapy exists. Sometimes, logistically it's just not possible. 3/
In these cases, we have to look at different methods that might not be as rigorous as the gold standard RCT and try to come to a conclusion through a confluence of studies. 4/
In the case of alternative medicine, however, particularly the highly implausible modalities (e.g., reiki, homeopathy), we can look at basic science and assess the likelihood that such therapies can work. That's called the pretest probability. 5/
For a modality like homeopathy to work, large swaths of well-established science in physics, chemistry, biochemistry, and physiology would have to be not just wrong, but spectacularly wrong. (Note that I leave the tiny possibility open that it could work.) 6/
Because that's true, we can conclude, using basic science considerations alone, that homeopathy is so incredibly implausible that its pretest probability is, for all practical intents and purposes, indistinguishable from zero. 7/
Another way to look at it: Basic science considerations alone tell us that homeopathy being effective to treat anything is so improbable as to be functionally indistinguishable from impossible. 8/
So, it's true. RCTs aren't the *only* valid method of scientific investigation of the efficacy of a treatment. They do, however, remain the gold standard for investigating a treatment with scientific plausibility based on preclinical scientific investigations. 9/9
