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letter
. 2016 Feb 15;109(2):46. doi: 10.1177/0141076815606279

Thomas Chalmers, vitamin C and the common cold

Harri Hemilä 1,
PMCID: PMC4793763  PMID: 26880652

Kay Dickersin and Frances Chalmers1 wrote that Thomas Chalmers ‘contributed substantially to the wave of meta-analyses in medicine which took off during the late 1970s and 1980s’. Chalmers’ meta-analysis on vitamin C and the common cold2 was mentioned as an example of the studies that provided statistically more robust estimates of treatment effects, but that is an unfortunate example.

In his 1975 meta-analysis, Thomas Chalmers calculated of seven placebo-controlled trials that common cold episodes were 0.11 ± 0.24 (SE) days shorter for the vitamin C groups than for the placebo groups.2

I showed in 1995 that in some cases Chalmers presented data that were inconsistent with the original data. Chalmers also made errors in the calculations and ignored the doses, and his selection of trials was inconsistent.3 I analysed the studies Chalmers had identified for which ≥ 1 g/d of vitamin C had been used and calculated that common cold episodes were 0.93 ± 0.22 (SE) days shorter in the vitamin C groups. Another measure of the effect was a 21% ± 3% (SE) reduction in the cold duration.3

Thomas Chalmers speculated that the benefit of vitamin C seen in some trials might be explained by the placebo effect.2 His suggestion was based on the Karlowski et al.’s trial,4 for which Chalmers was the principal investigator and about which he stated in 1996: ‘I am more proud of it than almost any other that I have published’.5 I showed in 1996 that the Karlowski trial was erroneously analysed, however.5

Chalmers’ meta-analysis and Karlowski’s trial largely quelled interest in vitamin C, and few trials have been carried out since the late 1970s.6 In any case, there is now very strong evidence that ≥1 g/d of vitamin C shortens the mean duration of colds in children by 18% and in adults by 8%.6

Declarations

Competing interests

None declared

References

  • 1.Dickersin K and Chalmers F. Thomas C Chalmers (1917-1995): a pioneer of randomised clinical trials and systematic reviews J R Soc Med 2015; 108: 237–241. [DOI] [PMC free article] [PubMed]
  • 2.Chalmers TC. Effects of ascorbic acid on the common cold. An evaluation of the evidence. Am J Med 1975; 58: 532–536. [DOI] [PubMed] [Google Scholar]
  • 3.Hemilä H, Herman ZS. Vitamin C and the common cold: a retrospective analysis of Chalmers’ review. J Am Coll Nutr 1995; 14: 116–123. [DOI] [PubMed] [Google Scholar]
  • 4.Karlowski TR, Chalmers TC, Frenkel LD, Kapikian AZ, Lewis TL, Lynch JM. Ascorbic acid for the common cold. A prophylactic and therapeutic trial. JAMA 1975; 231: 1038–1042. [PubMed] [Google Scholar]
  • 5.Hemilä H. Vitamin C, the placebo effect, and the common cold. A case study of how preconceptions influence the analysis of results [discussion in 49:1085–1087]. J Clin Epidemiol 1996; 49: 1079–1084. [DOI] [PubMed] [Google Scholar]
  • 6.Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev 2013; 1: CD000980–CD000980. [DOI] [PMC free article] [PubMed] [Google Scholar]

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