"Double blind trials are fine for pharmacological treatments but it's impossible to test other forms of therapy in this way."
Why not?
How else can physical effect be separated from placebo effect and anecdotal evidence?
New Study Exposes Acupuncture As Pseudoscience
by alecholmesthedetective 70 Replies latest social current
-
-
metatron
None of this answers the question of why placebos are so effective - even in surgery!
There are scientists making claims that the placebo effect seems to be becoming more powerful in drug trials. There are also continuing problems with double blind studies demonstrating hard effects - that are later disproved or strangely disappear.
AGAIN, this placebo effect has been in public view especially since Cousin's book many years ago. I doubt that any drug company ($$$) will ever find an explanation that interferes with cash flows.
metatron
-
LisaRose
None of the Cochrane reviews on acupuncture, acupressure, electroacupuncture and moxibustion can conclude with certainty that the treatments are ineffective.
The above is from the links provided. I am not trying to say that acupuncture is effective, I don't know enough about it one way or the other. I am just not convinced by these studies that it is not.
I read an interesting article in Wired magazine about placebos. They are finding that placebos are getting statistically better results over time. This is making it difficult for new drugs to get approved, as they don't show more of a benefit that the placebo. Many drugs now on the market (like Prozac) would not be approved today due to this. It makes you wonder, how could a sugar pill, or sham treatments be getting more effective?
http://www.wired.com/medtech/drugs/magazine/17-09/ff_placebo_effect?currentPage=2
-
fulltimestudent
LisaRose:
They are finding that placebos are getting statistically better results over time. This is making it difficult for new drugs to get approved, as they don't show more of a benefit that the placebo.
Interesting, isn't it?
And, even more interesting, it seems that the placebo effect may even extend to surgical therapy. Here's part of a report from ScienceDaily on a common knee procedure (Source: Baylor College of Medicine):
Study Finds Common Knee Surgery No Better Than Placebo
July 12, 2002 — HOUSTON (July 10, 2002) -- Patients with osteoarthritis of the knee who underwent placebo arthroscopic surgery were just as likely to report pain relief as those who received the real procedure, according to a Department of Veterans Affairs (VA) and Baylor College of Medicine study published in the July 11 New England Journal of Medicine.
The researchers say their results challenge the usefulness of one of the most common surgical procedures performed for osteoarthritis of the knee.
"The fact that the effectiveness of arthroscopic lavage or debridement in patients with osteoarthritis of the knee is no greater than that of placebo surgery makes us question whether the dollars spent on these procedures might not be put to better use," said lead investigator Dr. Nelda P. Wray, a health services researcher at the Houston VA Medical Center and Baylor College of Medicine in Houston.
In the study, 180 patients with knee pain were randomized into three groups. One group received debridement, in which worn, torn, or loose cartilage is cut away and removed with the aid of a pencil-thin viewing tube called an arthroscope. The second group underwent arthroscopic lavage, in which the bad cartilage is flushed out. The third group underwent simulated arthroscopic surgery; small incisions were made, but no instruments were inserted and no cartilage removed.
Source: http://www.sciencedaily.com/releases/2002/07/
020712075415.htm -
fulltimestudent
And, from the UK - results of a trial in which acupuncture was tried:
From Science Daily who rewrote a report in the British Medical Journal
Web address:
http://www.sciencedaily.com/releases/2012/08/
120820205054.htmAcupuncture Offers Low-Cost Alternative to Knee Surgery for Osteoarthritis, Research Finds
Aug. 20, 2012 — Acupuncture can relieve the pain of knee osteoarthritis and offer a low cost alternative to surgery for the condition, finds research published online in Acupuncture in Medicine.
The researchers base their findings on 90 patients with knee osteoarthritis, who were referred for group acupuncture to two knee pain clinics in St Albans, Hertfordshire, in 2008 and subsequently monitored for two years.
The clinics were set up in 2008 for NHS patients, and run in two GP practices by specially trained acupuncture nurses, to see whether this could improve care, while reducing costs, and offer a viable alternative to referrals for expensive knee replacement surgery (http://youtu.be/HX3ziJ_DNCQ?hd=1).
This type of surgery works well, and provides value for money, say the authors. But it is not suitable for everyone, and as many as one in seven patients experience severe pain a few years after the procedure.
It also costs £5,000 a pop, and knee osteoarthritis is common, causing significant pain in 17% of the UK population over the age of 50, they add.
Out of 114 patients who were offered acupuncture for osteoarthritic knee pain in 2008, 90 accepted and were treated in the clinics. Their average age was 71. All the patients referred to the clinics had severe symptoms -- constant pain, including at night, and inability to walk far -- and would have been eligible for surgery.
Fifty patients said they would be prepared to have surgery; four said they would only have the operation as a last resort; and 29 said they did not want surgery.
They were given acupuncture once a week for a month after which the frequency was reduced to a session every six weeks.
Forty one patients were still attending the clinics after a year, and 31 were still receiving treatment after two years. Each patient received an average of 16.5 treatments.
A validated score (MYMOP), used to measure symptom control, functional capacity, and wellbeing, showed clinically significant improvements in pain levels, stiffness, and functional capacity after one month of treatment. These improvements continued throughout the two year monitoring period, as assessed by MYMOP at six monthly intervals.
Based on the assumption that only two thirds of patients would take up an offer of acupuncture, the authors calculate that the service could save the NHS around £100,000 a year. Each treatment costs the NHS £20.
The authors also looked at the rates of total knee replacements for the three neighbouring commissioning groups after the service had been introduced.
They found that the group that had commissioned the service, which includes 13 general practices serving 180,000 patients, had the lowest rate, and that this was 10% lower than one of the other groups by 2011.
A second small study in the journal shows that group acupuncture was popular with both nurses and patients, and in an accompanying podcast (http://snd.sc/NaCdbu), a patient who underwent the treatment describes what a difference it has made to her life.
Story Source:
The above story is based on materials provided by BMJ-British Medical Journal.
Note: Materials may be edited for content and length. For further information, please contact the source cited above.
Journal References:
- A. White, M. Richardson, P. Richmond, J. Freedman, M. Bevis. Group acupuncture for knee pain: evaluation of a cost-saving initiative in the health service. Acupuncture in Medicine, 2012; DOI:10.1136/acupmed-2012-010151
- A. Asprey, C. Paterson, A. White. 'All in the same boat': a qualitative study of patients' attitudes and experiences in group acupuncture clinics. Acupuncture in Medicine, 2012; DOI: 10.1136/acupmed-2012-010150
-
jgnat
I tried a home remedy on hubby that worked like a charm. He used to suffer from cold sores. I told him that cold sores are worse with stress (true). I told him that B vitamins are good for stress (true). I found a bottle of B vitamins with a massive label on it, "STRESS" and told him the vitamins would cure his cold sores. The cold sores went away. He calls them his stress pills.
Placebo all the way, baby.
-
fulltimestudent
which brings me to:
hamsterbait:
Fulltime - I know an acupucturist :
The exams are very critical - Miss ONE point and you fail totally and have to resit. Also if you miss a point by a cm the patient would be in PAIN.
Try sticking pins in yourself and see!!
I appreciate that training for acupuncurists can be rigorous. But I'm also aware (at least in OZ) that not all those practising acupuncture may have rigorous training. I live in a suburb of Sydney gradually transforming into a Chinese suburb. There are now a number of small shopfront businesses practising TCM (Traditional Chinese Medicine) that apparently fill a need for Chinese residents. They will all offer acupuncture as part of their TCM service but I would not be able to assess their training or level of skill. Would you? I'm sure that there will be a skill differential between someone trained in the best of Chinese hospitals and someone who practised TCM in a village and learned from his predecessor. Likewise in Australia - the best training likely comes from a university degree, such as that offered by the University of Technology, Sydney, in their Faculty of Science. ( http://www.uts.edu.au/future-students/science ).
Details: http://www.uts.edu.au/future-students/find-a-course/courses/c10186
A clinic is situated in the Faculty of Science building. The clinic provides students with an opportunity to practise diagonostic skills. They examine patients and then report their diagnosis to a senior staff member, who also checks the patient and then critiques the student's diagnosis, and its the senior staff member who actually treats the patient.
Which is how I came to be treated by an associate Professor from the TCM department. His treatment works (for me, anyway).
Each visit (btw) costs around $25.00.
In comparison, I've been to an ordinary Doctor (a general practitioner) in my suburb, whose medical training has been in Aust. He also practises acupuncture (trained in Guangzhou). Treatments are free. He bulkbills his patients direct to Medicare, the national medical scheme.
I do not get the level of results from his treatment, that I get from the TCM clinic at UTS.
My conclusion: Not all acupuncturists have the same skill level.
But then, I do not believe that every allopathic Dr of Medicine, has the same level of skill, Some have great insight when diagnosising, whereas others may be more inclined to look up their handy (Drug company provided) reference book.
-
cofty
I am sure that our perception of our symptoms is vital. We can often choose to acknowledge pain signals for what they are and dismiss them or we can become focussed on them.
Can psychosomatic symptoms be distinguished from "real" ones?
Observing others in hospital wards and the way they choose to conquer or be conquered by pain is a revelation.
Perhaps treatments like acupuncture enable people to break their fixation on their symptoms.
-
fulltimestudent
Cofty:
Can psychosomatic symptoms be distinguished from "real" ones?
haha, Cofty, there are millions of worms in the can you are opening !!!
To start: "what is reality"?
To continue: If an atom is mainly empty space, what ARE we?
-------------------------------------------------------------------------------
But I mainly returned to this thread to share the thought that if we consider the use of acupuncture in traditional Chinese Medicine, Korean traditional medicine and traditional Japanese medicine (Kampo) plus users in S.E.Asia and tradtional Tibetan medicine you have a lot of people who use it.
Add to that, Indian medicine (Ayurveda) which some compare to homeopathy and in any case likely informed both Chinese medicine and Tibetan traditional medicine You have something like 3,000,000,000 people who are likely to use at least some section of that system for their health needs.
-
Ucantnome
i had acupuncture twice. once on my lower back and some time later on my shoulder. both times by the same person on the nhs. it seemed to work on my lower back but not on the shoulder although i could feel it more on the shoulder. said he had trouble getting the needles in the back.