Acupuncture appears to show results.

[Ivor the Engineer]

I hope you are not saying that you support homoeopathy because of its placebo effect!

No.

I wonder why my experience is different.

You are a nicer person than I am.

 

[fls]

'Tis true. While the content is apparently above reproach, the structure and manner of my reply does not conform to The Atheist's desires. 'Tis also horribly true that I don't care whether people agree with me or not.*

I'm perfectly willing to add to the 'points not under dispute on an acupuncture thread' list as necessary.

Linda
*I am aware that that makes me a freak.

 

[Ivor the Engineer]

<snip>

'Tis also horribly true that I don't care whether people agree with me or not.

<snip>

If true, it doesn't make you a freak, it makes you arrogant.

If you really don't care what people think of your ideas and opinions, why are you posting them on an internet forum?

 

[fls]

If true, it doesn't make you a freak, it makes you arrogant.

If you really don't care what people think of your ideas and opinions, why are you posting them on an internet forum?

The answer, as usual, is quite simple. That's not what I said.

Linda

 

[zosima]

Acupunture seems borderline, there are various studies that show very modest benefits, but its not clear if it is placebo, and if its not placebo then we have no idea how it works? Maybe its placedbo++, the fact that you really get poked, is even more convincing to your subconscious that you're getting treatment?

Here's a link to an article about its reported capacity to help with cocaine addiction:
http://www.sciencedaily.com/releases/2000/08/000814021638.htm

As the article states, acupuncture is cheap and has virtually no negative side effects...so if a benefit can be shown, thats awesome. Some insurance companies will actually pay for acupuncture for drug treatment, which says something. The acupuncture was performed on correctly on one group(ie correct acupuncture locations) and incorrectly on the other(ie dummy acupuncture locations) and the correct locations showed more efficacy for drug treatment. I'm not 100% about this last part, but I think they may have even double blinded it, by training new acupuncturists with incorrect locations for the control. Which is at least double blinded to a first order approximation. Maybe I'll try to dig up the primary source tomorrow...

That said, I've tried acupuncture and I'm pretty skeptical meself, it didn't seem to do anything...but then again, neither does aspirin.

 

[fls]

http://archinte.ama-assn.org/cgi/content/abstract/160/15/2305

 

[fls]

Of note, 15 out of 28 participants dropped out of the acupuncture group, 10 out of 27 dropped out of the sham acupuncture group, and 5 out of 27 dropped out of the control relaxation group. The difference between the sham and true accupuncture group had a p-value of 0.05, but this was under the assumption that dropping out had nothing to do with whether or not you had relapsed. If you consider it possible that at least some of those people who dropped out did so because they failed the program, there are no significant differences between the treatment groups.

Linda

 

[Ivor the Engineer]

How did the paper get past peer review when its enthusiastic conclusion is so at odds with a reasonable interpretation of the results?

 

[BillyJoe]

Why did they use a "relaxation therapy" control?
They give a reason but it doesn't make sense. All that was required was that the true and sham acupuncture groups experienced the same relaxation protocol.


Why was there a difference in the way the needle was inserted in the True and Sham groups:

For the True Acupuncture group:

Needles were inserted into the cartilage at each point such that they were perpendicular to the surface of the ear..

For the Sham Acupuncture group:

Needles were not inserted into the cartilage at each point; rather, they were inserted subcutaneously, at an oblique angle.

They say it was to avoid giving active treatment to the Sham Acupuncture group! Isn't it sufficient just to use different acupuncture points. All they have done is supply another means by which the two treatments can be distinguished.


There was also an absence of adequate blinding:

the acupuncturist was not blinded with respect to treatment assignment and patients were only partially blinded.

And there were insufficient numbers in each group and an unacceptably high drop-out rate:

(13/28) completed auricular acupuncture (17/27) completed the needle-insertion control, and (22/27) completed the relaxation control.

They ended up effectively comparing 13 True Acupuncture patients with 17 Modified Sham Acupuncture patients, where there was no blinding of the acupuncturists and only partial blinding of patients!

 

[Phytotherapist]

Linda - In Italy I'm not allowed to award qualifications. Medical qualifications are awarded by medical schools (all public) and can be checked by anyone on the web. It is very easy to find the qualifications of all MDs working in Italy. I checked the qualifications of them all and that of 9 MD School Profs of the top Italian universities that have endorsed the research and, of course, I've read all the papers.

Are you allowed to put the word Prof before your name? Are you teaching your students to jump to conclusions before fully reading a report? What are your qualifications in Neurology, Neurosurgery, Anesthesiology and Acupuncture?

I run the 5 Km better than you may think but I'd probably need 6 years to knit a sweater.

 

[fls]

Linda - In Italy I'm not allowed to award qualifications. Medical qualifications are awarded by medical schools (all public) and can be checked by anyone on the web. It is very easy to find the qualifications of all MDs working in Italy. I checked the qualifications of them all and that of 9 MD School Profs of the top Italian universities that have endorsed the research and, of course, I've read all the papers.

It wasn't entirely clear that the qualifications you were referring to were medical, since I would usually expect someone who is qualified in the area of clinical research to be able to design a study with an appropriate control group. Regardless of how you personally feel about these researchers, they did not use a control group that could answer the question that they asked.

Are you allowed to put the word Prof before your name?

I am.

Are you teaching your students to jump to conclusions before fully reading a report?

Despite pretenses otherwise, my conclusions did not depend upon any information that I did not have. I made a comment on what I suspected a particular result might show, but it was redundant to my conclusion. It is a rather pathetic point, so I suppose that I should feel flattered that that is all you seem to be able to come up with.

What are your qualifications in Neurology, Neurosurgery, Anesthesiology and Acupuncture?

I'm not sure that qualifications in those areas would serve me as well as my qualifications in clinical research design and evidence-based medicine. My criticism was of their study design rather than their needle-insertion technique, after all.

However, I would like to point out that several other people here, without (as far as I know) any specific medical qualifications, were also able to easily see this flaw.

Linda

 

[Phytotherapist]

Linda - I doubt you're a Prof and I doubt about your medical qualifications. You are just arrogant!

 

[Phytotherapist]

In Italy it is very hard to become a Medical School Prof. I myself tried hard and didn't succeed. I am an MD have 3 State Universitiy degrees, 2 doctorates and 2 specialisations, speak 5 languages (English is the worst), I was for 3 years the CEO of a 10+ figures company and I did't succeed in becoming Prof. although I tried very hard.

And than someone that doesn't even know a word in Latin pretends to give lessons in Medicine. Every doctor should know Latin. In which language are you going to prescribe if you are, say, in Germany?

 

[fls]

Linda - I doubt you're a Prof and I doubt about your medical qualifications. You are just arrogant!

Actually, there was a conversation here about whether or not 'Doctor' was a protected title and I seem to recall that it wasn't. I wonder if 'Professor' is even a protected title, or whether anyone can make up business cards with that title.

Linda

 

[fls]

In Italy it is very hard to become a Medical School Prof. I myself tried hard and didn't succeed. I am an MD have 3 State Universitiy degrees, 2 doctorates and 2 specialisations, speak 5 languages (English is the worst), I was for 3 years the CEO of a 10+ figures company and I did't succeed in becoming Prof. although I tried very hard.

I'm sorry to hear that. It sounds like it was important to you.

And than someone that doesn't even know a word in Latin pretends to give lessons in Medicine. Every doctor should know Latin. In which language are you going to prescribe if you are, say, in Germany?

Yeah, I also think it is useful to know Latin (especially for Medicine). My daughter was given the choice of Chinese (presumably Mandarin) or Latin for next year. She chose Chinese, I think because she is fascinated with Japan. Should I advise her to change? She does like to collect different language dictionaries and does already have some familiarity with her Latin dictionary.

Linda

 

[Jeff Corey]

Normal Dude has sent me the whole report mentioned in the OP. I'm on the road now, but when I get to the university, I'll print it out and share it with others who teach design and stat. At first glance, there seems to be something fishy about the data used in the factorial ANOVA. There were initial group differences in the pain ratings that could readily have been eliminated by a percent change of score conversion.
More later.

 

[Ivor the Engineer]

I've heard Greek is another useful language to know if medicine is your thing.

(Not knowing anything about Japanese) Would knowing Mandarin help? E.g., German doesn't help with French, but Italian and Spanish are pretty similar.

ETA: Looking at Wikipedia, it seems it would.

 

[Rolfe]

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.

Er, what do you know about the qualifications of anyone on this forum? Me, say? Or JJM? Or Badly Shaved Monkey? Or DeeTee? Or fls? Or Pipirr? Or Wilsontown?

I don't think you have any idea at all who you're talking to.

Reminds me of Dana Ullman, asserting that none of us had the "scientific chops" to get anything published in relation to the homoeopathy trials we were critiquing. Resulted in the submission of a Letter to the Editor of the journal which published the study, signed by four PhDs. Letter was accepted, and the author's "right of reply" was essentially a capitulation.

So before you say that anyone is "certainly" more qualified than anyone on this forum, perhaps you should research the qualifications of the members of the forum.

Rolfe.

 

[Rolfe]

acupuncture is cheap and has virtually no negative side effects....

Only if you don't count sepsis of the needle punctures, or traumatic pneumothorax, as negative side effects....

Oh, you said "virtually". So that's OK then.

A few years ago I attended what I thought was a meeting on computerisation of the clinical laboratory. It was a bit more wide-ranging than that, and the highlight of the show was Dr. Bandolier himself using the literature on acupuncture as an Awful Illustration of how to be misled by slanted presentation of clinical trials.

At one point he answered an audience question about acupuncture with, "sure, go ahead, as long as you realise it doesn't work and it can kill you".

The incidence of harm is probably low, though I don't think I'd like to let anyone who believes in a medical philosophy which doesn't accept the germ theory of disease stick needles in me. However, there is no structured reporting mechanism for such harm to be recorded (in sharp contrast to real medical procedures). Harm is certainly possible, and it certainly has happened, and we are merely making assumptions when we state that it is uncommon.

The possibility of benefit seems wildly over-rated.

So I'm really not in favour of encouraging people to charge money for this exercise, and promote it, and claim benefits for it, and encourage sick people to submit to it.

Rolfe.

 

[BillyJoe]

Linda - I doubt you're a Prof and I doubt about your medical qualifications. You are just arrogant!

And than someone that doesn't even know a word in Latin pretends to give lessons in Medicine.

I read this this morning and I had an excellent reposte which I had goddamn forgotten by the time I got home tonight

You are a lucky boy.