Acupuncture appears to show results.

[JJM]

I accept these results because I've carefully checked the qualifications of all the people involved in this research and they are certainly more qualified than any member of this Forum. {snip}

Checking the qualifications of the researcher is like checking the size of chimneys to see if Santa Claus could really exist and deliver Christmas presents.

In science, we evaluate the work, not the worker. It is more trouble; but, it is safer.

 

[Jeff Corey]

I accept these results because I've carefully checked the qualifications of all the people involved in this research and they are certainly more qualified than any member of this Forum. Moreover, there are no economic interests behind this research.

There doesn't have to be any economic interests to motivate experimenter bias and not controlling for that potential confounding variable in a study that employs a subjective measure is bad science.

 

[INRM]

From what I was told,

The way acupuncture works, it would seem by positioning a needle near a nerve which results in endorphin release.

There's also power of suggestion...

 

[The Atheist]

Now all we need is someone who can detect the methodological flaws.

I'd nominate that for pith if I could be bothered editing in the other quotes for context.

I accept these results because I've carefully checked the qualifications of all the people involved in this research and they are certainly more qualified than any member of this Forum. Moreover, there are no economic interests behind this research.

That's all correct and I see that Dr Facco has previously rubbished attempts to claim aletrnatives worked, but as has been noted, even the best doctors and researchers can make mistakes, so accepting his results on the basis of his reputation isn't necessarily a good thing.

From what I was told,

The way acupuncture works, it would seem by positioning a needle near a nerve which results in endorphin release.

That's what I'd always figured as well.

And even a medical dork like me notices that the ailments treated in those studies always are of the rather fuzzy kind, like headache, migraine, the not-feeling-good stuff and everyday come and go ailments like "argh, my back hurts".

Yep, me too - especially migraines. Maybe we should do a double-blind study on "kissing it better". (I suspect the study would be more enjoyable, too!

 

[fls]

I accept these results because I've carefully checked the qualifications of all the people involved in this research and they are certainly more qualified than any member of this Forum. Moreover, there are no economic interests behind this research.

That's a good idea - trust people based on whether or not they pass your qualifications. In my case, you must run a 5K in under 22 minutes or knit a sweater back in under 6 hours.

Linda

 

[fls]

I'd nominate that for pith if I could be bothered editing in the other quotes for context.

I must admit, I'm a bit surprised that you got that joke.

Linda

 

[The Atheist]

I must admit, I'm a bit surprised that you got that joke.

Linda

This is what I like about you - the ability to make a comment like that.

Linda - do you mind if I call you Linda?

This is about the third or fourth thread I've participated in where you've had lots to type. The first post you made is such a classic example that I didn't bother answering it.

If I could be bothered finding the other threads, I'd merely link to the replies, because your position is remarkably similar in every one, and therefore mine will be as well.

When it comes to the placebo effect, our perception of relief is strongly related to our expectation.

Lovely explanation - thanks.

And there's no getting around the fact that acupuncture is very good at setting up expectations. It's dramatic, mysterious and ritualized. And as soon as you give some clues that expectations should be reduced (such as clues as to whether you are getting sham acupuncture), you see a corresponding reduction in the perception of relief. The fewer clues you give that you may be receiving a sham treatment, the closer the results between the sham and the true acupuncture. When you get to the point where you give no discernible clues (needles pierce the skin at non-acupoint places, the provider is blinded), the results are indistinguishable.

Again, a perfectly lovely description of testing.

But in all that, you've actually made no relevant comment whatsoever, barring a sweeping "we can't tell the difference"!

The description of this study allows for discernible clues. So in the end, we can't tell whether the results reflect expectation or whether there is some effect specific to the sticking of needles in our body. As others have pointed out, we are long past the point where the results, even if specific to the sticking of needles in our body, reflect any evidence for TCM.

Another brilliant piece of writing, immediately introducing TCM as a strawman. Who the hell mentioned TCM? (I even had to look that up - not an acronym I'd ever seen, because it's not something I have any interest in.) Just because a study is being done into acupuncture, why raise ginseng and herbal tea? If we dismissed all fields of traditional medicine as bunkum and never followed any of the bits they were using, we'd never have tried using plant extracts to cure diseases, because that's old-fashioned bunkum.

Seriously, your strawman ability is only matched by the Danish bloke.

It shouldn't even be called acupuncture, since the 'where' has nothing to do with qi.

Ah, it's the name acupuncture you object to.

I'd say 99% of the people in the world who have ever heard the word "acupuncture" would associate it with needles being inserted into the flesh in a medicinal usage. How many of them think it works, I have no idea - probably quite a few.

Can you think of a better reason to call it a different name than "I don't like it"?

Instead of associating acupuncture with qi - wouldn't a smarter move be to remove the association while studying the possible benefits?

There is another point in this, which I have belaboured you with in the past - how do you know that what works as a placebo on a patient can be replaced by another form of medicine, traditional or not? Even worse, your attitude smacks of "placebos are just placebos, toss 'em all out", which I'm not at all convinced is a sensible idea where pain is concerned.

Again, a narrow-minded approach to a broad problem.

I don't think it's unreasonable to experiment with physical modalities for pain relief (we already use other techniques), but we may as well divorce the use of needles from something called acupuncture, since the ideas behind TCM add nothing to our understanding, at this point.

"At this point"? Oh my word.

Can I translate that to:

RANT, unless something happens to change my mind.

See above - both for TCM and needles.

I don't have access to the full text, right now.

And all that without even reading the whole thing. I had tears streaming down my face after reading this.

Why would you bother writing all that about something you hadn't even read fully? Again, this is Larsenism at its best. Your position here is identical to his on Dean Radin. Because he'd read a book, he ranted against the bloke. Because you don't like acupuncture, you've ranted against this study, but without even knowing more than a paragraph about it!

See, you might even be right - as I've pointed out to you in other threads - but you are doing the sceptical and scientific worlds no favours at all. You write as though you have some authority on the subject, yet you've stated in other threads that you aren't even a doctor. I submit that you are at least as likely to fool the uninitiated as any well-trained "woo"-ist. I have no position on alternative medicine other than accepting that if there were value in any of it, then science would probably be aware of it.

Given that there might well be a positive effect in some of these things, my enquiring nature insists that we check out some of the more likely ones, and needles stimulating the flesh/nerves/skin seems a possibility. Fear of needles keeps blood donations to around 4% of the population, and creates an incalculable number of non-vaccinated people so any study to do with needles might be beneficial to us. As I noted above, you would have it all given up and swept away under the "alternative" label. In case you hadn't noticed, there are a quite a few people who believe body & soul in alternative medicine world and the more of it science can embrace as real, the more likely people are not to be fooled by charlatans.

I suspect (because they didn't report on this in the abstract) that the pain relief from true acupuncture was not significantly different from the sham acupuncture groups.

You "suspect"?

Sherlock Bleeding Holmes, is it?

Since when do we "suspect" in medicine?

Thank christ you aren't a doctor!

The other problem with this study is the low numbers (less than 50 per group) and the high drop-out rate (21 percent). And what I found weird was that not only did they have the wrong comparison group in order to answer their question, they didn't even report on the differences between the comparison group that they did use and the treatment group (in the abstract). Which is why I suspect that there was no difference and that their conclusion is unsupported by the results.

Basically, this study tells us nothing we don't already know.

Linda

You almost make some good points here, but as always, you spoil yourself with the ending:

Basically, this study tells us nothing we don't already know.

You have just dismissed a study you haven't even read.

Genius.

 

[fls]

This is what I like about you - the ability to make a comment like that.

I am always happy to be of service. In this case, it appears that your enjoyment depends upon assuming a number of characteristics that are probably unreasonable. However, I feel safe that pointing that out won't change your assumptions, so my reply should not lessen your amusement.

Linda - do you mind if I call you Linda?

Not likely to get me mixed up with anyone else by calling me that, so "no".

This is about the third or fourth thread I've participated in where you've had lots to type. The first post you made is such a classic example that I didn't bother answering it.

If I could be bothered finding the other threads, I'd merely link to the replies, because your position is remarkably similar in every one, and therefore mine will be as well.

Lovely explanation - thanks.

Again, a perfectly lovely description of testing.

But in all that, you've actually made no relevant comment whatsoever, barring a sweeping "we can't tell the difference"!

It was meant to be an introductory paragraph, not (yet) specific to the paper. 'Tis true that I am unable (though I continue to try) to guess exactly how much background is necessary in order for my subsequent comments to make sense. But overall, I'd rather give too much, than too little, so thank you for letting me know I succeeded.

Another brilliant piece of writing, immediately introducing TCM as a strawman. Who the hell mentioned TCM? (I even had to look that up - not an acronym I'd ever seen, because it's not something I have any interest in. Just because a study is being done into acupuncture, why raise ginseng and herbal tea?

It was mentioned in the very first sentence of the article you linked to. I made the assumption (apparently foolishly?) that you had read the article that you referred to.

If we dismissed all fields of traditional medicine as bunkum and never followed any of the bits they were using, we'd never have tried using plant extracts to cure diseases, because that's old-fashioned bunkum.

That may be, but it doesn't really have anything to do with what I said.

Seriously, your strawman ability is only matched by the Danish bloke.

Which you have chosen to prove by dissing one of the main connections made in the article itself (i.e. I did not initiate the connection) and by making reference to something I did not say? Super well done!

Ah, it's the name acupuncture you object to.

The word 'acupuncture' refers to a specific technique from Traditional Chinese Medicine (TCM).

I'd say 99% of the people in the world who have ever heard the word "acupuncture" would associate it with needles being inserted into the flesh in a medicinal usage. How many of them think it works, I have no idea - probably quite a few.

I agree. With the addition that I would expect many people would also associate it with 'Chinese' or 'Chinese Medicine'.

Can you think of a better reason to call it a different name than "I don't like it"?

Yes. I would prefer something that more accurately reflects what we are and are not talking about.

Instead of associating acupuncture with qi - wouldn't a smarter move be to remove the association while studying the possible benefits?

Yes, and one way to remove the association is to refrain from using the word which has the effect of strengthening the association.

There is another point in this, which I have belaboured you with in the past - how do you know that what works as a placebo on a patient can be replaced by another form of medicine, traditional or not?

We have done a lot of research on the specific characteristics of placebos that are responsible for inducing expectations. I'm suggesting that we could make use of that information, and even continue to explore it further.

Even worse, your attitude smacks of "placebos are just placebos, toss 'em all out", which I'm not at all convinced is a sensible idea where pain is concerned.

That is not my opinion on the issue.

Again, a narrow-minded approach to a broad problem.

Yes, it would be.

"At this point"? Oh my word.

Can I translate that to:

RANT, unless something happens to change my mind.

Isn't that the point? We go where the evidence leads us rather than attempting to cling to something the evidence is pulling us away from?

And all that without even reading the whole thing. I had tears streaming down my face after reading this.

Excellent!

Why would you bother writing all that about something you hadn't even read fully? Again, this is Larsenism at its best. Your position here is identical to his on Dean Radin. Because he'd read a book, he ranted against the bloke. Because you don't like acupuncture, you've ranted against this study, but without even knowing more than a paragraph about it!

I have a lot of practice reading abstracts and full texts of research studies. There are consistent patterns in how results are reported. In particular, it is extremely unlikely (I've not seen it happen, but that's not to say it couldn't) that a researcher would fail to report what would be the most exciting and mind-blowing result in a particular study in favour of reporting a more mundane result. However, I specifically mentioned that my comments were not based on reading the full text in order to indicate that my opinion was based on incomplete information. I fully realize the difference.

See, you might even be right - as I've pointed out to you in other threads - but you are doing the sceptical and scientific worlds no favours at all.

I'm flattered that you've elevated my position, but really, posting on a general internet forum shouldn't really be considered participating in science (including scientific discussion). I'm not sure that what we do here has much to do with the sceptical world, either.

You write as though you have some authority on the subject, yet you've stated in other threads that you aren't even a doctor.

That can't be true. I wouldn't lie about something like that (if only because I'm too absent-minded to remember to be deceitful).

I submit that you are at least as likely to fool the uninitiated as any well-trained "woo"-ist. I have no position on alternative medicine other than accepting that if there were value in any of it, then science would probably be aware of it.

I certainly hope I am likely to fool the uninitiated, since it is one of the things I have taught to medical students and medical residents/interns as part of my role as an academic physician. Evaluation of clinical research is probably the main thing that I teach.

Given that there might well be a positive effect in some of these things, my enquiring nature insists that we check out some of the more likely ones, and needles stimulating the flesh/nerves/skin seems a possibility. Fear of needles keeps blood donations to around 4% of the population, and creates an incalculable number of non-vaccinated people so any study to do with needles might be beneficial to us. As I noted above, you would have it all given up and swept away under the "alternative" label.

If it's any consolation, you made up that last bit about me (i.e. whether or not you want to consider it true doesn't seem to have much of anything to do with what I've said, so you are free to follow your own inclinations).

In case you hadn't noticed, there are a quite a few people who believe body & soul in alternative medicine world and the more of it science can embrace as real, the more likely people are not to be fooled by charlatans.

It would be interesting to discover whether or not that would be the case. I used to think so, but my experience is changing my opinion.

You "suspect"?

Sherlock Bleeding Holmes, is it?

Since when do we "suspect" in medicine?

Thank christ you aren't a doctor!

Are you serious?

You think something like "I suspect you have pneumonia, but I'd like to get more information by taking a chest x-ray" would never be uttered? You need to get out more.

I guess Christ didn't do a very good job for you, though.

You almost make some good points here, but as always, you spoil yourself with the ending:

You have just dismissed a study you haven't even read.

Genius.

I can read the signs. What would be an important discovery, if present, is not mentioned in the abstract in a study published in a relatively low impact journal instead of a high impact journal. You're right. It could still be present. But then you'd have to assume the authors weren't too bright.

Linda

 

[The Atheist]

Which you have chosen to prove by dissing one of the main connections made in the article itself (i.e. I did not initiate the connection) and by making reference to something I did not say? Super well done!

Way to deliberately miss the point, even after I mentioned ginseng. You were using TCM as an all-inclusive term. There's no question that acupuncture is one part of it, which is why I gave you the example of plant-extracts, just in case you decided to miss the first clue.

Thanks for playing.

Evaluation of clinical research is probably the main thing that I teach.

Well, that, in connection with this:

I can read the signs.

...is truly scary.

So can astrologers.

 

[The Atheist]

You think something like "I suspect you have pneumonia, but I'd like to get more information by taking a chest x-ray" would never be uttered? You need to get out more.

Nice swerve again. In your own post, you failed to seek the further evidence. You would be the doctor who suspects pneumonia but never gets the x-ray. You are deliberately mispresenting your own position.

Again.

I'm over it.

 

[JJM]

{snip} So can astrologers.

If you think astrologers read signs in any meaningful way, you need help. Try www.skepdic.com

 

[Ivor the Engineer]

In TA's defence, I too was initially confused what Linda did for a living after having a few conversations with her. My initial guess was Biostatistian.

Linda,

What are your thoughts on the placebo effect? I must admit from reading your posts in this and other threads, I have the impression you do not rate its component parts as useful in the practice of medicine.

 

[fls]

Way to deliberately miss the point, even after I mentioned ginseng. You were using TCM as an all-inclusive term. There's no question that acupuncture is one part of it, which is why I gave you the example of plant-extracts, just in case you decided to miss the first clue.

Thanks for playing.

I see. That wasn't my intention. When I said, "we may as well divorce the use of needles from something called acupuncture, since the ideas behind TCM add nothing to our understanding, at this point", I meant that we may as well divorce the ideas behind TCM specific to the use of acupunture. Looking back on it, I realize that I didn't indicate that's what I meant, other than context.

Well, that, in connection with this:

...is truly scary.

So can astrologers.

See?!! I told my English teacher that metaphors will only get you into trouble!

Linda

 

[The Atheist]

If you think astrologers read signs in any meaningful way, you need help.[/url]

Fortunately, I don't.

The only time I find reading signs at all helpful is when I'm hunting.

Linda's sign reading seemed to have much in common with astrology - many words, little value.

In TA's defence, I too was initially confused what Linda did for a living after having a few conversations with her. My initial guess was Biostatistian.

Linda,

What are your thoughts on the placebo effect? I must admit from reading your posts in this and other threads, I have the impression you do not rate its component parts as useful in the practice of medicine.

There you go - I'll just see how you get on.

 

[fls]

Nice swerve again. In your own post, you failed to seek the further evidence. You would be the doctor who suspects pneumonia but never gets the x-ray. You are deliberately mispresenting your own position.

Again.

I'm over it.

I'm happy to change it for you (in order to avoid confusion).

"Are you serious?

You think something like "I suspect you have pneumonia" would never be uttered? You need to get out more."

Most of the time here I base my comments on gathering all the available information. The few times I don't have all the information, I make sure I state that, because I agree that sometimes it changes the matter. Under those circumstances I also qualify my statements with words like "suspect" or "wonder", and I specify what information I would be looking for. In this case, the information that was missing because I hadn't read the full text was whether or not there was any difference between the true acupuncture and sham acupuncture groups when it came to pain relief. I said that I "suspected" a particular result based on the usual reporting practices, but I thought it was pretty clear that that information was unknown at that point. The information that I based my final conclusion on was available - the size of the groups, the drop-out rate, and most importantly, the nature of the comparison groups. Quite simply, I already had all the information that was necessary. The part that I "suspected" was redundant (avoiding unnecessary radiation and all that).

Linda

 

[fls]

Linda,

What are your thoughts on the placebo effect? I must admit from reading your posts in this and other threads, I have the impression you do not rate its component parts as useful in the practice of medicine.

I consider it very useful.

Linda

 

[fls]

Linda's sign reading seemed to have much in common with astrology - many words, little value.

In all honesty, I expect you to get very little use from what I say. I mostly responded for the benefit of those people who find what I say useful.

I'm going to stick this in my sig, just so's I don't have to repeat it. You are free to pay no attention to me. I won't even hold it against you.

Linda

 

[BillyJoe]

In TA's defence...

There is not much to say in TA's defence.
He has completely misunderstood, mischaracterised and misresponded to Linda's posts.
He has had a bad hair day but has yet to look at himself inthe mirror, but that is hardly an excuse.

Linda, What are your thoughts on the placebo effect? I must admit from reading your posts in this and other threads, I have the impression you do not rate its component parts as useful in the practice of medicine

You are incredible, Ivor!
You don't even have to rely on your impressions from other threads because Linda has given her opinion of the placebo effect right here in this thread.
And she was responding to you TA!!! So, again, you have no excuse. You need to find a comb though.

 

[The Atheist]

There is not much to say in TA's defence.
He has completely misunderstood, mischaracterised and misresponded to Linda's posts.

Hey, you're welcome to disagree - but please show where I have been guilty of the claims you make.

I don't think I've done any of it, but have dissected a couple of lengthy but non-informative posts which the author has admitted were made on the basis of not having even read the complete report.

He has had a bad hair day but has yet to look at himself inthe mirror, but that is hardly an excuse.

What?

When I stuff up, as I have many times, I have demonstrably stood up and admitted it, so you're just wrong with this one.

As usual with this sort of thing, I start a thread to have a reasonably intelligent discussion on a subject. A poster posting same opinionated rubbish on every subject, sweeping it away with a bunch of unsupported generalisations doesn't cut the mustard, for me.

If you're able to point out any actual relevant comments made by Linda in her initial posts, go ahead, because she's still batting .000 from where I'm sitting.

 

[Acleron]

There's no suggestion that "qi" is resposible for benefits from acupuncture, but a study by an Italian specialist seems to have produced some interesting results:

Details here.

The doctor involved seems to be a recognised specialist in pain therapy, so it looks like it will be a well-controlled and performed test.

Going back to the OP, why do you think because it seems that he is a specialist in pain therapy the trial should be well controlled?

The reference you supplied makes no mention of blinding, an essential part of any trial involving subjective assessment.