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Acupuncture study

Professor Yaffle said:
Kumar, go and read this http://en.wikipedia.org/wiki/Attention and don't come back until you have thoroughly misunderstood it and incorporated it into one of your flights of fancy.
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I already read but Physical basis and physiological affects as a result of attention and concentration are no where indicated.

Anyway, can these be concentration of psychlogically stumulated physiological activities by attention at a partcular point?
 
EHLO said:
Hi Zep, I'm intrigued, can you point me to some good examples of refutations published by such journals. (style/format etc). I assume it needs to be more than just a letter to the editor.

As someone with absolutely no authority in the field I doubt my view as a concerned citizen would carry much weight with the editors. I'm happy to give it a go though…
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Heh! :) My father-in-law was an MD and surgeon, so I got to read his MJA's regularly. So I have seen plenty of refutations, but alas can't point you to them specifically. The usual format of a refutation would be either as a letter-to-the-editor (often polite but stiff) or as another study.

Can I suggest you ask Truthseeker, Badly Shaved Monkey or Rolfe initially about how to prepare and deliver a proper refutation to a respected journal, especially a medical one. They are the ones I do know myself who are reasonably regularly published themselves. And I invite all the other scientists here who get published regularly to chip in with advice and help!
 
Kumar said:
I already read but Physical basis and physiological affects as a result of attention and concentration are no where indicated.

Anyway, can these be concentration of psychlogically stumulated physiological activities by attention at a partcular point?
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Yes.

And No.
 
Zep said:
Finally, the single-blinding of accupuncture tests is an old problem - it is difficult to "sham" accupuncture, especially if patients have had it before and know how it should feel.
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They could have tested the blinding, by asking patients what they thought they were getting. This is often done, and I think is essential in this case where double blinding is impossible. Note that they didn't exclude patients who had ever had acupuncture, only those who had it in the previous 2 years. It's entirely possible that they recruited enough patients who knew what genuine acupuncture is, to bias the study. Also the sham technique they used is not state of the art. When `stage dagger' needles are used there is usually no significant superiority for penetrative needling.

I ran this study past a few colleagues, and one of them spotted the regression to the mean problem that Deetee explains so well.

At the back of my mind is the nagging thought that we are really scratching around for ways to discredit this study. But I think we are being fair. Extraordinary claims need extraordinary evidence, and CAM studies need to be more rigorous than those in orthodox medicine, not less. This is because CAM modalities are hard to study on a `black box' basis - they always involve a complex interaction of patient, practitioner and `treatment'.

Kumar - please take note that I am ignoring your posts now, however annoying they may be, because you never make the slightest sense. I suggest everyone else does the same.
 
Asolepius said:
At the back of my mind is the nagging thought that we are really scratching around for ways to discredit this study. But I think we are being fair. Extraordinary claims need extraordinary evidence, and CAM studies need to be more rigorous than those in orthodox medicine, not less. This is because CAM modalities are hard to study on a `black box' basis - they always involve a complex interaction of patient, practitioner and `treatment'.
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Agreed - it does feel a bit grubby looking for holes when I know where my biases lay. Had the story that got my interest in the first place been about a drug trial I probably wouldn't have thought twice about it.

Having said that I don't know how the researchers can say in one breath "we don't know how it works", and then in another carry on about meridians and energy flows. That really bugs me.
 
EHLO said:
Agreed - it does feel a bit grubby looking for holes when I know where my biases lay. Had the story that got my interest in the first place been about a drug trial I probably wouldn't have thought twice about it
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I'm not excusing drug trials by any means, but generally it's easy to double-blind those. Thus we are justified in not scrutinising that aspect of them quite as much. The regression to the mean error is another matter, and would be spotted by a reviewer of a dossier submitted for drug marketing. Bear in mind that a study for such a dossier would be very much larger and the baseline imbalance therefore much less likely.
 
Asolepius said:
I'm not excusing drug trials by any means, but generally it's easy to double-blind those. Thus we are justified in not scrutinising that aspect of them quite as much.
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Actually, it's a good practice to watch the blinding procedures in drug trials, too. The placebo won't produce 'side effects' such as nausea, insomnia, appetite suppression, or whatever, which a patient will notice. Well-designed controls mimic the side effects of the experimental drug so patients can't confound the study.

Additionally, I always recommend analysing the entire intention-to-treat cohort. Discovering anomalies in the assignment of patients can reveal that the experiment is not as blinded on the experimenter's side as perhaps claimed to be.
 
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