Articles

Archive for Acupuncture

A very special issue of Medical Acupuncture

Every so often, our “friends” on the other side of the science aisle (i.e., the supporters of “complementary and alternative medicine”—otherwise known as CAM or “integrative medicine”) give me a present when I’m looking for a topic for my weekly bit of brain droppings about medicine, science, and/or why CAM is neither. It’s also been a while since I’ve written about this particular subject; so it’s a win-win for all sides! I get a topic. A certain CAM journal gets extra traffic. And you get the benefit of my usually brilliant deconstruction of dubious science. What could go wrong? I mean, I might not be Mark Crislip, but I do enjoy a good dive into a pile of pseudoscience every now and then. It’s just a weird trait of mine.

In any case, there is a journal called Medical Acupuncture. Sadly, it’s published by a real scientific publisher, Mary Ann Liebert, Inc., a publisher that has a stable of decent, if not top tier, journals. Unfortunately, it also has a stable of CAM journals, including, of course, the aforementioned journal Medical Acupuncture. Because I happen to be on the mailing list for Mary Ann Liebert, Inc., I recently got an e-mail with an announcement:

How Does Acupuncture Work? The Science behind the Therapy Is Explored in a Special Issue of Medical Acupuncture

New Rochelle, NY, April 16, 2013—Even as medical acupuncture is increasingly being validated as an effective treatment for a broad range of medical conditions, what has been missing is an understanding of the basic science and mechanisms of action of this age-old method of healing. A special issue of Medical Acupuncture, a peer-reviewed journal published by Mary Ann Liebert, Inc., publishers presents a series of articles by authors from around the world who provide diverse and insightful perspectives on the science and physiologic responses underlying medical acupuncture. The issue is available free on the Medical Acupuncture website.

“Understanding acupuncture in the same manner that we understand the mechanism of action and pharmacokinetics of a particular drug will, similarly, enable us to match treatments better with conditions,” states Guest Editor Richard F. Hobbs, III, MD. “The net effect will be improved outcomes,” he writes in his editorial “Basic Science Matters.”

(more…)

Posted in: Acupuncture

Leave a Comment (74) →

AAFP CME Program Succumbs to “Integrative Medicine”

For many years I have been using Continuing Medical Education (CME) programs offered by the American Academy of Family Physicians (AAFP). The FP Essentials program consists of a monthly monograph with a post-test that can be submitted electronically for 5 hours of CME credit. Over a 9-year cycle, a complete family medicine curriculum is covered to prepare participants for the re-certification board exams. Some examples of typical subjects are skin cancer, hand and wrist injuries, valvular heart disease, and care of the newborn. I rely on these programs to learn, review, and keep up-to-date in my specialty. Imagine my dismay when I opened the latest package to find a monograph on Integrative Medicine.

First it was called various names like folk medicine, quackery, and unproven/untested treatments, then all of those (the less rational right along with the more rational) were lumped together under the umbrella term “Alternative Medicine,” then it became “Complementary and Alternative Medicine” (CAM), and now it has been re-branded as “Integrative Medicine.” The term is designed to make unscientific treatments seem more acceptable to science-based doctors. “Integrative Medicine” is a marketing term, not a meaningful scientific category. It is a euphemism for combining Complementary and Alternative Medicine (CAM) with mainstream medical practice, unproven with proven, magic with science.  It has been critiqued many times on this blog. We have stressed that there is only one medicine, and that when a treatment is proven to work by good evidence, it is just “medicine.” When the evidence for a CAM treatment is not good, it essentially amounts to experimental treatments and/or comfort measures. Worse, sometimes CAM even persists in using treatments that have been proven not to work or that are totally implausible, like therapeutic touch or homeopathy. (more…)

Posted in: Acupuncture, Cancer, Energy Medicine, Medical Academia

Leave a Comment (11) →

Acupuncture and Allergic Rhinitis: Another Opportunity for Intellectual Sterility

You need to keep an open mind.

A common suggestion offered to naysayers of nonsense.

The usual retort concerns not letting one’s brain fall out.

Evaluating SCAM’s is less about having an open mind and more about having standards, a conceptual framework that is used to interpret and analyze new information. One of the benefits of writing and reading topics covered by science-based medicine (SBM) is it has clarified and sharpened the ideas by which I understand the world. Those concepts were nicely summed up by Steve Novella at Neurologica, and I reproduce them here, slightly modified. They should be on stone tablets, not quite commandants, but strong suggestions. The 8 strong suggestions somehow doesn’t cut it however. (more…)

Posted in: Acupuncture, Clinical Trials, Science and Medicine

Leave a Comment (67) →

Legislative Alchemy: Acupuncture and Homeopathy 2013

Acupuncture, or more broadly, Oriental or Traditional Chinese Medicine, is a

weird medley of philosophy, religion, superstition, magic, alchemy, astrology, feng shui, divination, sorcery, demonology and quackery.

And via the particular form of magic known as legislative alchemy, acupuncture is a licensed health care profession in 44 states and the District of Columbia.

A growing body of evidence demonstrates acupuncture is simply an elaborate placebo. Even the CAM-friendly National Center for Complementary and Alternative Medicine, says

Although millions of Americans use acupuncture each year, often for chronic pain, there has been considerable controversy surrounding its value as a therapy and whether it is anything more than placebo.

Someone should tell the state legislatures. (more…)

Posted in: Acupuncture, Homeopathy, Legal, Politics and Regulation, Traditional Chinese Medicine

Leave a Comment (11) →

Bogus Electrodermal Testing Devices and the Failure of Regulators to Act

Electrodermal testing is a bogus procedure where measurements of skin conductance with a biofeedback device are entered into a computer to diagnose nonexistent health problems and “energy imbalances” and to recommend treatments for them, often involving the sale of homeopathic remedies and other useless products. It falls under the general category of EAV (Electro Acupuncture of Voll). The history and variants of EAV are explained in an article on Quackwatch.

I’ve written about electrodermal testing before. I’ve explained how it amounts to fooling patients with a computerized Magic 8 Ball and I’ve discussed the legal and regulatory issues.

Now Stephen Barrett (founder of Quackwatch and Vice-President of the Institute for Science in Medicine) has written an article in FACT (Focus on Alternative and Complementary Therapies) entitled “Bogus electrodermal testing devices: where are the regulators?” He points out that existing regulations are sufficient to ban these devices, but that regulators have failed to take appropriate action.

(more…)

Posted in: Acupuncture, Energy Medicine, Medical devices, Politics and Regulation

Leave a Comment (13) →

California Acupuncture Licensing: Sinking Lower in the Slime!

The sun shone down upon that putrescence,
As if to roast it to a turn,
And to give back a hundredfold to great Nature
The elements she had combined…
— Charles Baudelaire, The Carcase1

Trouble for the struggling California Acupuncture Board (Board) is far from being over.

After being taken to task by the California Senate less than a year ago for acting “as a venue for promoting the profession” rather than regulating it, now the Board is being petitioned for reform by license applicants after a major compromise in the California Acupuncture Licensing Examination (CALI). This is the exam that allows the graduates of state-approved training programs to practice acupuncture, herbalism and Asian massage in California. Physicians who use these modalities are regulated by the Medical Board.

Bear in mind that California is the only state in the nation that has its own acupuncture licensing examination. In other states where the profession is regulated, candidates have to take a battery of computer-based tests developed by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). The California test is designed by the Department of Consumer Affairs, and could be taken in English, Chinese or Korean. This means that an individual can get licensed and practice healthcare in California, without understanding a word of English!
(more…)

Posted in: Acupuncture, Politics and Regulation

Leave a Comment (79) →

Systematic Review claims acupuncture as effective as antidepressants: Part 1: Checking the past literature

acupuncture

A recent systematic review in PLOS One raised the question whether acupuncture and other alternative therapies are as effective as antidepressants and psychotherapy for depression. The authors concluded

 differences were not seen with psychotherapy compared to antidepressants, alternative therapies [and notably acupuncture] or active intervention controls

or put it differently,

antidepressants alone and psychotherapy alone are not significantly different from alternative therapies or active controls.

There are clear messages here. To consumers: Why take antidepressants with their long delay and uncertainty in showing any benefits–but immediate side effects and potential risks–when a few sessions of acupuncture work just as well? To promoters of acupuncture and alternative therapies: you can now cite an authoritative review in the peer-reviewed PLOS One as scientific evidence that your treatments is as effective as scary antidepressants and time-consuming psychotherapy when you make appeals to consumers and to third-party payers.

The systematic review had five co-authors, of whom three have been involved in previous meta-analyses of the efficacy of antidepressants. However, fourth author Irving Kirsch will undoubtedly be the author most recognizable to consumers and policymakers, largely because his relentless media campaign claiming antidepressants are essentially worthless, no better than placebo. For instance, in an interview with CBS 60 Minutes Irving Kirsch: The difference between the effect of a placebo and the effect of an antidepressant is minimal for most people.

Irving Kirsch: The difference between the effect of a placebo and the effect of an antidepressant is minimal for most people.
(more…)

Posted in: Acupuncture, Neuroscience/Mental Health, Science and the Media

Leave a Comment (32) →

SCAMlandia

I quite like Portlandia. I find it funny and it captures a part of Portland. I recognize large swaths of the city’s culture in the show. Other representations of the city I recognize less. Sunset publishes beautiful photographs of the NW, but when I look at the photos I think, that section of the city never looks that good. It is quite wonderful how Photoshop can improve on reality.

Like most major cities, Portland has a monthly magazine, Portland Monthly. The city represented in that magazine is mostly alien to me. I look at the advertisement, the articles, the photographs, and wonder when did Portland become a city with an average 7 figure income? The Portland in which I grew up and currently live is rarely found in the pages of Portland Monthly. If you are extremely well to do, I suppose you are in the demographic Portland Monthly. But when I flip through the pages of the magazine, I see little I recognize, but I have never completely abandoned the hippie/grunge aesthetic of my younger days.

Every January they have the best Doctors issue* and this year, for the first time, they offer The Portland Alternative Medicine Guide. Well, less a guide and more an extended infomercial filled with ‘facts’ that deserve the quotes. (more…)

Posted in: Acupuncture, Chiropractic, Dentistry, Energy Medicine, Homeopathy, Legal, Naturopathy, Politics and Regulation, Science and Medicine, Traditional Chinese Medicine

Leave a Comment (19) →

Alternative Arthritis Treatments

A recent report commissioned by Arthritis Research UK reviewed 25 so-called “alternative” therapies for arthritis. They found, not surprisingly that there is little evidence to support most the studied treatments.

“There’s either no evidence that they’re effective or there’s some evidence that they are not effective.

Says lead author, Dr Gareth Jones.  It is important to note that we are not just talking about that these treatments are poorly studies, but also that to the extent they are studied the evidence is mixed or shows lack of efficacy.

I want to discuss, however, the exceptions – the treatment the report found were effective. They include acupuncture, tai chi, yoga, and massage.  Tai chi and yoga are basically forms of exercise and stretching, so it is not surprising that they are helpful in treating musculoskeletal disorders. It is deceptive, in my opinion, to even consider them “alternative” and lump them into the same artificial category as copper bracelets and magnet therapy. Exercise is not alternative – it is a very basic form of science-based activity for health, conditioning, and for musculoskeletal symptoms. The same is essentially true for massage, which is known to relax muscles (at least temporarily). Relaxation therapy should also not be considered “alternative” and existed long before this category was invented.

The only item on the list of treatment modalities that the report concluded showed some efficacy that is reasonably defined as “alternative” was acupuncture. This claim caught my attention because other reviews of the literature indicate that acupuncture is not effective for arthritis (or anything else). The report itself is not published in a peer-reviewed journal (at least not yet), but the lead author, Gareth Jones, has published prior systematic reviews.

(more…)

Posted in: Acupuncture

Leave a Comment (76) →

Journal of Clinical Oncology editorial: “Compelling” evidence acupuncture “may be” effective for cancer related fatigue

Journal of Clinical Oncology (JCO) is a high impact journal (JIF > 16)  that advertises itself as a “must read” for oncologists. Some cutting edge RCTs evaluating chemo and hormonal therapies have appeared there. But a past blog post gave dramatic examples of pseudoscience and plain nonsense to be found in JCO concerning psychoneuroimmunology (PNI) and, increasingly, integrative medicine and even integrations of integrative medicine and PNI. The prestige of JCO has made it a major focus for efforts to secure respectability and third-party payments for CAM treatments by promoting their scientific status and effectiveness.

Once articles are published in JCO, authors can escape critical commentary by simply refusing to respond, taking advantage of an editorial policy that requires a response in order for critical commentaries to be published. An author’s refusal to respond means criticism cannot be published.

Some of the most outrageous incursions of woo science into JCO are accompanied by editorials that enjoy further relaxation of any editorial restraint  and peer review. Accompanying editorials are a form of privileged access publishing, often written by reviewers who have strongly recommended the article for publication, and having their own PNI and CAM studies to promote with citation in JCO.

Because of strict space limitations, controversial statements can simply be declared, rather than elaborated in arguments in which holes could be poked. A faux authority is created. Once claims make it into JCO, their sources are forgotten and only the appearance a “must read,” high impact journal is remembered. A shoddy form of scholarship becomes possible in which JCO can be cited for statements that would be recognized as ridiculous if accompanied by a citation of the origin in a CAM journal. And what readers track down and examine original sources for numbered citations, anyway?
(more…)

Posted in: Acupuncture, Cancer, Clinical Trials, Energy Medicine, Neuroscience/Mental Health, Traditional Chinese Medicine

Leave a Comment (13) →
Page 6 of 18 «...45678...»