Both Steven Novella and Orac posted today about the recent acupuncture study that supposedly shows acupuncture works better than real medicine. Both Orac and Novella’s posts examine the study and its weaknesses in some detail and so I won’t try to do the same. But I do have a couple of brief points I want to make about this study and acupuncture studies in general, and before I do that I’ll have to briefly summarize the main points of this study.
The researchers, amongst other things, wanted to compare the effectiveness of acupuncture on pain, compared with “groups receiving standard medical care.” Remember that phrase. “Standard medical care” essentially means whatever their physicians had already prescribed for each patient – medical treatments or physical therapies. Remember that. The study divided the test patients into four groups, namely:”
- “Standard medical care” plus individualized acupuncture.
- “Standard medical care” plus standardized acupuncture
- “Standard medical care” plus sham acupuncture (toothpicks that didn’t penetrate the skin)
- “Standard medical care” only.
The reports of the study generally don’t describe the first three groups in quite that way, but the above is a correct description of what they actually did – all four groups continued with the standard treatment their doctors had prescribed before.
The result was that: there was no significant difference between groups 1, 2 and 3, but groups 1, 2 and 3 were each better than group 4. This is being reported as “both real and sham acupuncture better than conventional treatment”. But the study shows no such thing. There are (at least) three fundamental flaws with this conclusion, namely:
- The study wasn’t blinded. This means there was no real control for placebo, and so any comparisons of acupuncture with the conventional treatment are worthless.
- All three acupuncture groups had conventional treatment as well as acupuncture, so the study can not possibly show that acupuncture is better than conventional treatment. For that to be even possible, the acupuncture groups would have had to be acupuncture only – no conventional treatment. This is such an obvious “duh” point I don’t know whether to laugh or cry that apparently even the researchers didn’t think it was important.
- Sham acupuncture was (again) just as good as the ‘real”stuff. But this does not mean that sham works as well as non-sham acupuncture, as has been reported. As Steven Novella wrote, when your real treatment is no better than your placebo (the “sham” acupuncture), you don’t get to conclude that, well, this means the placebo works too. No – you conclude the real treatment doesn’t work.
Worthless Acupuncture Studies
Yet again we have a worthless acupuncture study that is being falsely touted as showing acupuncture works. Again, this study is on supposed pain reduction. What about all the other things that acupuncture is supposed to fix? It releases blocked qi, yes? Shouldn’t it do more than reduce pain? Look at this list: Acupuncture: Conditions it Treats - Gastrointestinal Disorders, Urogenital Disorders, Gynecological Problems – the list goes on and on. So why are we always shown pain reduction only?
Second, why do acupuncture researchers always end saying something like this study “raises some new questions about how acupuncture works”? No it doesn’t. It shows it doesn’t work.
And third, why do they always call for more studies? Josephine P. Briggs, MD, director of NCCAM, is quoted saying:
Future research is needed to delve deeper into what is evoking these responses."
Why? There is enough research already for us to conclude that acupuncture is a placebo.
I’m going to make a prediction. Before this year is out, there will be at least one more study of acupuncture that shows “sham” acupuncture is as good as the “real” stuff, and / or that acupuncture is better than an (unblinded) non-acupuncture group. The researchers will say (1) this shows there is something going on with acupuncture, and (2) we need more studies to be done on acupuncture. More studies will be needed. I guarantee it.
Rinse and repeat next year, the year after…
Articles by Steven Novella:
Several posts by me: