Thursday, January 29, 2009

Acupuncture: forget the qi & meridians...AND any strong placebo effect

...even more dead in the water than thought.
There is an interesting research study published January 2009 regarding acupuncture treatment for pain. The most interesting thing about it is that it seems acupuncture isn't even much of a placebo, let alone anything else related to real healng. The second most interesting development as a result of this study is the almost comical cognitive dissonance from several media players as well as acupuncture apologists.

DC's improbable science has the goods and excellent discussion regarding the study and some of the sadly predictable -albeit quite athletic- false positive mental "spin" on the obviously negative implications for the institution that is acupuncture itself.

Dr Colquhoun notes in the comments section that even "modern" acupuncture denuded of the archaic and imaginative sophistry of "qi", points or meridians is dealt what could be a fatal blow:

"It’s true that the Medical acupuncture people, Adrian White et al. have abandoned the hocus pocus, and seem happy to admit that it doesn’t matter where the needles go. But that was already well-established before these last lot of reviews.

It was also quite well established already that in a non-blind comparison of acupuncture versus no acupuncture, the acupuncture wins.

The really new thing in the Madsen paper is that although acupuncture still beats no acupuncture, the advantage is too small to be much use to patients. So it may be a theatrical placebo, but the placebo effect isn’t big enough to matter in real life.

If this conclusion is confirmed by others, then acupuncture is dead. You can’t even make the (morally-dubious) argument that it’s a good placebo."
(my bold)

It's important to note that non-blind studies severely limit the quality of interpretations, especially for elucidating any effects beyond a placebo. Other superior studies clearly reveal no putative acupuncture effects beyond chance or placebo. In essence, as the study design improves acupuncture effects disappear.

Remember, this particular study relates to the very nebulous, variable and personal concept of pain- a realm fraught with confounding factors. Many studies regarding acupuncture effects deal with these rather subjective areas because that's pretty much what is left as the search for bigger effects has proven fruitless. If it is this hard to tease out any real acupuncture effect here from the a back ground noise of probability, acupuncture -as a legitimate medical modality- has a big, big problem.

Yet some people just don't get it...and the credulous will likely still drink deep from the twisted rhetorical kool aid and "feel" good.

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