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.

Trusting the medical literature

really nothing new...as always... just take it with a grain of salt
Dr RW has an interesting post where he responds to Dr Marcia Angells JAMA commentary where she questions the ability to practice evidence based medicine noting that "Physicians can no longer rely on the medical literature for valid and reliable information".

Though, as pointed out by Dr RW, there are prescient challenges and significant problems reagrding industry and non-industry supported research, Dr Angells assertion -reminiscent of the "pharma is all evil" canard- indeed seems far too simplistic.

Unfortunately, her opinion -though important and worth measured consideration- may be taken as fact and used by the ideological or the less scientifically literate to distract from a more balanced approach to considering a litany of real problems. Indeed, the research landscape is far from the useless state Dr Angell seems to claim.

As Dr RW notes:
"What then are practicing doctors to do? Angell’s statement above suggests that in the current environment the practice of evidence based medicine and science based medicine are impossible. Nonsense. EBM is premised on the fact that all research reports have weaknesses and are to be viewed with skepticism. SBM, recognizing that EBM lacks the tools to examine all claims, goes a step further by evaluating reports in light of prior research and scientific plausibility. In short, doctors have the tools to critically appraise the medical literature. It’s hard to believe Dr. Angell wants to abandon EBM altogether."
(My bold)

Hopefully that is not her intent. Dr Angell does seem to favor an "independent body" to serve as overseer and provider of clinical trails...an option fraught with many of the same problems beguiling the present research environment.

In the end, as these issues are -hopefully- objectively and pragmatically addressed, Dr RWs' call to using evidence and science based approaches and tools when evaluating data will continue to serve practitioners and their patients well.

"Storm" live by Tim Minchin

Just too good to let slip by....

Tim Minchin graciously provided for purview a wonderful live version of STORM

(lyrics posted here).

Enjoy....

Case studies in debunking fallacious thinking: anti-vaccine apologists and acupuncture "effects"considered

Here are three fabulous examples of lucid and clear analysis in action against the dogma and fallacy of ideological thought - critical thinking at it's best.

Respectful Insolence: Can we finally just say that acupuncture is nothing more than an elaborate placebo? Can we?

Heal Spiel: Response to antivaccination parent

Neurologica: Some follow up on migraines

These excellent fellow bloggers confront psuedo-science with clear, referenced, factual and reality based discussion cooly eviscerating delusional thinking; whether confronting antivaccine supporter claims or analyzing putative acupuncture "effects".

Very refreshing and stimulating...think I'll do a post on an animal related psuedo-science issue soon.

Cectic on skepticism

WildEarth

....live and close up

The WildEarth.TV site is a great way to experience the fascinating world of the African wild in an intimate and interactive way.

"LIVE wildlife broadcasting is set to become an important part of natural history TV, why not join the experts and help make the revolution a reality ... it's in your nature."

Very cool!

Elevating Science, Elevating Democracy

Very nice and well written piece in the New York Times.

"The knock on science from its cultural and religious critics is that it is arrogant and materialistic...So the story goes...But this is balderdash. Science is not a monument of received Truth but something that people do to look for truth."