Saturday, September 5, 2009

Swedish acupuncture research a sham?

Is most of acupuncture research done in Sweden a sham itself?

As I wrote in a previous post, I regard research done with sham acupuncture is to be regarded with sceptisicm since we should not regard these methods as useless.

Research done in Sweden is as far as I know done by physiotherapists and other personell withing the monoploized Swedish health care system. Acupuncturist with longer educadion has little access to research. The problem with this is that the ones doing the research do it after a quick course of two weeks to get to know how to put acupuncture needles into someone after a schedule given at the course.

Doing medical research requires knowledge about chemistry and how cells and receptors work. Should acupuncture studies not be perform the same way? Using practisioners with years of education and experience of acupuncture. Persons that have knowledge how to interpret the symptoms that each patient present and know how to adjust the treatment accordingly.

We know that adjusted acupuncture description during the course of treatment give better result than following a scheme given for a specific condition. All individuals is different and also the symptoms, acupuncture treatments should be given with considderation of what is seen in every individual case. Of course this makes it more difficult to research but should the method have to adapt to a way to research or should the research adapt to the method? If we have a map and should go out in the nature and the nature have changed, should we then regard that the nature can not be prooven to be true since it does not fit the map?

In my opinion, the research should be done by real acupuncturists in a way that is similar to how acupuncture is used in a real setting. Not in a setting that is adjusted in a way to make statistics easy to use.

Wednesday, September 2, 2009

The problem with sham as placebo in acupuncture studies

Most acupuncture studies applies sham acupuncture as a mean to use placebo in acupuncture studies.

As John Amaro writes in his article at Is Most of Acupuncture Research a "Sham?",

"Acupuncture research conclusions cannot be accepted as long as the research is being conducted as shown in the examples I cited. True blind or double-blind studies may essentially be impossible within acupuncture research due to the fact as long as a patient is able to feel a sensation at the point of needle contact (whether actual or simulated), it cannot be considered a valid blind study. The methods utilized in most acupuncture research are without question, a "sham.""

it is not possible to use sham acupuncture as placebo. Placebo is supposed to be without any effect and since sham acupuncture is designed to simulate the de Qi sensation I would say that they are using a placebo-method that is not without an effect.

Sham needling is shallow or just in contact with the skin. Japanese acupuncture has a philosophy of inserting needles shallow or not at all, so called touch needling, and still get effect. Japanese acupuncturist also have the aim to insert the needle with as little pain or sensation for the patient as possible.

Researchers should look beyond Chinese acupuncture and a little bit more to Japanese practitioners, specially Manaka that did a lot of research in acupuncture. Before applying bad study designs which usually show bad results, research should be done on the X-factor as described by Manaka in the "Chasing the Dragons tail". Which also elaborates the effects of needling on the same side contra the opposite side of pain. Reserch should also be done on how different needling methods gives signals in the body osing MRI and other tools not as poorly designed studies with sham acupunture as controlling element.