What alternative health

practitioners might not tell you

 

ebm-first.com

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"The reason I ask this question is because yet another large meta-analysis has been released that is entirely consistent with the hypothesis that acupuncture is a placebo…..There's a reason why acupuncturists don't like sham-controlled studies. If you review them, you'll see that the preponderance of evidence from such studies shows that (1) it doesn't matter where acupuncturists stick the needles, and the effect is the same no matter where they are stuck; and (2) acupuncture produces no effects greater than placebo. That's because it is a placebo. It's an elaborate placebo, and the relaxation and attention given patients is the only real "healing" going on." Orac at Science Blogs (29th January 2009)

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"A new review appeared in the BMJ today. It is by Madsen et al., from the Nordic Cochrane Centre, Copenhagen…..The results confirm, yet again, that there is essentially no difference between "real" acupuncture and sham acupuncture. All that talk about meridians and Qi really is so much mumbo jumbo…..Madsen et al conclude "a consensus report characterised a 10mm reduction on a 100 mm visual analogue scale as representing a "minimal" change or "little change". Thus, the apparent analgesic effect of acupuncture seems to be below a clinically relevant pain improvement."" Professor David Colquhoun, DC Science (28th January 2009)

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"…after 3 decades of intensive research, is the end of acupuncture nigh? Given its many supporters, acupuncture is bound to survive the current wave of negative evidence, as it has survived previous threats. What has changed, however, is that, for the first time in its long history, acupuncture has been submitted to rigorous science—and conclusively failed the test." Edzard Ernst, MD, PhD, The American Journal of Medicine (December 2008) [pdf]

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"It's time the acupuncture myth was punctured — preferably with an acupuncture needle. Almost everything you've heard about acupuncture is wrong.….all the current evidence is compatible with this hypothesis: acupuncture is nothing more than a recipe for an elaborate placebo seasoned with a soupcon of counter-irritant." Harriet Hall, MD, Science Based Medicine (21st October 2008)

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"Acupuncture has also been studied enough for the technology of acupuncture research to have matured to fairly definitive studies, and to conclude that there is probably no large or easily detectable biological effect from acupuncture. In addition, the popularity of acupuncture (while still small in absolute numbers) far outstrips the evidence for its effectiveness, making acupuncture a controversial treatment. This controversy is exacerbated by the existence of dedicated practitioners (acupuncturists), who have a vested interest in this one modality. For these reasons any further testing of acupuncture should aspire to the highest scientific standards. Pilot studies of acupuncture are worse than worthless — they do nothing to further the scientific question, and they are abused to promote a dubious treatment through the credulous media." Steven Novella, MD, Science Based Medicine (24th September 2008)

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"The bottom line is that this study is yet another of a long line of studies of "complementary and alternative" medicine that are entirely consistent with the placebo effect. Worse, it didn't even really try to distinguish between a treatment effect and placebo effect." Orac at Science Blogs (28th August 2008)

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"Taken as a whole, the pattern of the acupuncture literature follows one with which scientists are very familiar: the more tightly controlled the study the smaller the effect, and the best controlled trials are negative. This pattern is highly predictive of a null-effect — that there is no actual effect from acupuncture." Steven Novella, MD, NeuroLogica Blog (25th August 2008)

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Plans to offer new science degrees in acupuncture and Chinese herbal medicine at the University of Central Lancashire have met fierce opposition — from the university's own staff. Times Higher Education Supplement (7th August 2008)

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A new study looking into whether acupuncture is useful in helping women undergoing IVF treatment to get pregnant has concluded that acupuncture has no effect on the success rate. After comparing real acupuncture to fake acupuncture and doing nothing, the pregnancy success rates were the same in all three groups. BBC News report (8th July 2008)

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"A study published early February in the British Medical Journal examined the link between acupuncture and successful in vitro fertilization…..The authors pooled the seven studies in a meta-analysis to find that the odds ratio — the odds of pregnancy through IVF and acupuncture divided by the odds of pregnancy through IVF without acupuncture — was 1.65. Here the word 'odds' is used in the statistical sense, not the layman meaning…..The media reported this figure as if acupuncture increases the success rate of IVF *by 65 percent*, misunderstanding what is meant by the odds ratio. The actual increase in pregnancy likelihood according to this meta-analysis is about ten percent. This alone makes the results far less impressive than they sound." Rebecca Goldin Ph.D, and Jenna Krall, STATS (3rd March 2008)

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"Dozens of RCTs of auricular acupuncture have been published; many of them have generated positive results. Close scrutiny, however, reveals that most of these studies are methodologically weak. Whenever the totality of the evidence is critically evaluated, as for instance in the case of auricular acupuncture for cocaine dependence, the results are either cautious or totally negative: 'There is currently no evidence that auricular acupuncture is effective …..In summary, auricular acupuncture is based on a bizarre concept that has little or no biological plausibility. The trial evidence is mixed but, on critical assessment, far from convincing. Of course, we should keep an open mind — but let us be careful that in doing so our brains do not fall out." Professor Edzard Ernst, debate published in Focus on Alternative and Complementary Therapies [FACT] (March 2008)

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"These researchers learned something, but not what they think they learned. They learned that doubling the PPI [Proton Pump Inhibitor] dose is pretty much useless, and that providing a placebo intervention is much more effective. To my mind, the next logical step would be to find the simplest, most effective method to help the patient in the same way that they were helped by acupuncture placebo, but without any make-believe about imaginary meridians and qi. If the authors' speculations about light touch are correct, it's quite possible that some form of light massage would be equally effective. And perhaps personal attention, relaxation, and reassurance would do even more good. We may be able to learn a great deal from alternative medicine practices, but not necessarily what they would like to teach us. All the acupuncture research to date is compatible with the hypothesis that it's nothing more than an elaborate placebo with maybe a touch of counter-irritant thrown in. No one has seen a meridian or measured the qi. Isn't it time to stop doing junk science and Tooth Fairy research, to discard needles and meridians and mystical nonsense, and to try reality-based approaches to improving patient comfort and satisfaction?" Harriet Hall, MD, Science Based Medicine (12th February 2008)

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"In the end, this is a negative study, no matter how much its authors may try to spin it as anything other or speculate that acupuncture might have worked if they had continued the treatment longer. It's also the reason why you probably haven't heard about it, as you can bet that a major study like this from a research powerhouse like Memorial Sloan-Kettering Cancer Center published in a very widely read, high impact journal like the Journal of Clinical Oncology would have been trumpeted to every news outlet in the land if it had shown a statistically significant decrease in hot flashes in women in the "true" acupuncture group. It didn't; so it wasn't." Orac at Science Blogs (19th December 2007)

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Yet another study has been published allegedly showing that "acupuncture works." The study is published in the journal Anesthesiology and looks at post operative nausea and vomiting. There are many problems, however, with the conclusions drawn from the study and it does not support the claims of acupuncture… I do not find this one study compelling. The acupuncture and nausea literature is generally negative and inconsistent. The acupuncture literature in general tends to be negative and is solidly negative with regard to the reality of chi, meridians, and acupuncture points. The literature is also contaminated by many studies, like this one, that are not actually looking at acupuncture but at other things, such as electrical nerve stimulation. The net effect of such studies is not to improve the practice of medicine or increase our knowledge of biology or medical treatments, but as a source of misdirection in order to promote demonstrably false and unscientific beliefs to the public." Steven Novella, MD, NeuroLogica Blog (10th December 2007)

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"I think it is important to dispense with the superstitious nonsense that still surrounds acupuncture so we can focus on these remaining questions. Is there any benefit to acupuncture above the placebo effect? Is the needle insertion a necessary component of the acupuncture treatment? (So far I find the evidence unconvincing on these questions.) If it does work, what is the underlying physiological mechanism and are their easier and less invasive ways to exploit it? Acupuncture must free itself from its superstitious roots to more effectively address these questions, to be taken seriously, and to avoid the chronic problem of CAM where positive findings in a very narrow area are used to justify a large system of pseudoscience." Article by Steven Novella, MD, academic clinical neurologist at Yale University School of Medicine, NeuroLogica Blog (25th September 2007)

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"I look at it this way: what if acupuncture didn't exist?…Would medicine or society be any worse off? If no one knew about it, nothing would change. You would still have ways to apply counter-irritation, through massage or rubbing." Article by Wallace Sampson, clinical professor emeritus of medicine at Stanford University and editor in chief of the Scientific Review of Alternative Medicine (San Francisco Chronicle — 31st August 2006)

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A critical review of part one of the BBC2 series 'Alternative Medicine: The Evidence' which looked at acupuncture. By David Colquhoun, FRS, A. J. Clark Professor of Pharmacology, University College London (January 2006) [Also see the link immediately below]