Cohort studyindependent cross-checkabstract only checked★ key study I-CHM-04 in-depth review
Refusing standard cancer treatment, not complementary medicine itself, raised the risk of death
Complementary Medicine, Refusal of Conventional Cancer Therapy, and Survival Among Patients With Curable Cancers.
Overview
Johnson SB et al.. JAMA Oncol 2018 · PMID 30027204 · DOI 10.1001/jamaoncol.2018.2487
Users of complementary medicine refused chemotherapy or radiotherapy far more often and had about twice the risk of death.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Study CM and survival.
- How was the study done?
Registry cohort.
- How many people, animals or samples were studied?
258 vs 1,032.
- What was actually found?
HR 2.08; explained by refusal.
- How large was the observed effect?
5-y OS 82.2% vs 86.6%.
- What do the results mean in everyday life?
Diet or other approaches alongside treatment are not the problem; replacing treatment is.
- What are the study's limitations?
Observational.
- What does it say about Elawady's specific claim?
Contradicts refusal advice.
- Do the results apply to Germany and Europe?
Moderate.
- What can explicitly not be concluded from this study?
Causal effect of any single CM.
Scientific in-depth review
1. Full reference
- Authors
- Johnson SB et al.
- Journal
- JAMA Oncol
- Year
- 2018
- Identifier
- PMID 30027204 DOI 10.1001/jamaoncol.2018.2487
- Verification
- verified – PubMed esummary + efetch 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
Survival and treatment adherence with complementary medicine plus conventional treatment.
3. Study design and population
- Study design
- Cohort study – Retrospective matched cohort (National Cancer Database)
- Population
Nonmetastatic breast, prostate, lung, colorectal cancer 2004-2013
- Country
USA
- Period
2004-2013
- Sample size
1,901,815 total; 258 CM vs 1,032 matched controls
- Inclusion and exclusion criteria
CM plus >=1 conventional modality
4. Methods and endpoints
- Exposure / intervention
Complementary medicine
- Comparator
No CM
- Endpoints
Overall survival; treatment refusal
- Statistical methods
Matching; Cox models with/without refusal
5. Actual results
- Results
CM users refused more surgery (7.0% vs 0.1%), chemotherapy (34.1% vs 3.2%), radiotherapy (53.0% vs 2.3%), hormone therapy (33.7% vs 2.8%). 5-year OS 82.2% vs 86.6%; HR 2.08 (1.50-2.90). After adjusting for refusal/delay: HR 1.39 (0.83-2.33), not significant.
- Absolute risks
5-year overall survival 82.2% vs 86.6%
- Authors' conclusion
Mortality risk associated with CM was mediated by refusal of conventional treatment.
6. Strengths
- Very large database
- Mediation analysis
7. Weaknesses
- Observational
- CM recording incomplete
8. Risk of bias
- Orienting tool
- ROBINS-E
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Misclassification and residual confounding.
9. Assessment of the statistical interpretation
Points to refusal of effective treatment as the mechanism of excess deaths.
10. Relevance to the specific claim
Shows the harm lies in refusing or delaying conventional therapy.
11. Independent contrary findings
12. Transferability to Germany and Europe
Moderate.
13. Overall methodological judgement
Important mediation evidence: complementary approaches are not the danger per se; refusal is.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
- Cancer patients should not take chemotherapy, radiotherapy or biological therapy (or should stop them) and follow the Tayebat system instead; 'we are against the word medicine'. – Studies contradicting or limiting the claim
- The archive's 19 chemo/radiation studies are presented on the homepage as 'scientific studies confirming what Dr. Diaa proposed'; the harm-only study selection implies that the harms of chemotherapy and radiotherapy outweigh their benefits. – Studies contradicting or limiting the claim
- Cancer will respond to the Tayebat system; a patient with a malignant tumour should start the system now (diet as cancer treatment). – Studies contradicting or limiting the claim
- In his practice he treats cancer with fasting (fasting every other day) and by reducing solid foods; he himself can go for days without food, on sugar-cane juice only. – Studies contradicting or limiting the claim