Monday, October 1, 2007

Three Strikes and you're out (Part 2)

So where were we? Oh yes, I was wittering about people's anti-scientific attitude and how, due to all the hard-to-understandness that comes with sciencey things people are choosing in their droves (sheep analogy might be better) to believe something much more understandable and appealing to their uncritical personalities, but which are fundamentally, incorrect.

Acupunture is a bit of a classic. It's got needles, history (the chinese were apparently using it 14 billion years ago), drama, excitement, mysticism, religiousity and theatre all rolled up into one non-offensive therapy. The question, as always, is does it show any benefit over placebo?.

Well, that depends not on the results but on the newspaper you read. A well-documented story in the paper last week (covered by Ben Goldacre in his excellent Bad Science column in the Saturday Guardian) gave details of research that suggested that acupuncture was better than no acupuncture, but no better than random pin insertion. I'm not going to cover it here - the full dialogue on the Bad Science website is well worth the read.

So that's "Strike 2".

Strike 3 is very similar to strike 2, and actually means a lot more to me personally. (Can you believe it has taken this long for me to get to the point of why I'm writing this? Must learn to be more succinct.)

Despite being 30 years old, both my hips are crumbling as we speak due to osteoarthritis. Bummer. Nothing outside very invasive surgery will do anything for it - science fact. That doesn't stop everyone telling you that chondroitin will re-hipify you or that without glucosamine you will die before dawn.

The experience has given me insight into why people are taken victim to these therapies despite any proof of cure (outwith placebo) - when there is little hope, any hope (regardless of what it involves) shines brightly.

And so to the study; it was a randomised multi-centre controlled trial to investigate the benefit of adding acupuncture to a course of advice and exercise delivered by physiotherapists for pain reduction in patients with osteoarthritis of the knee.(Published in BMJ 2007;335(7617):436 (1 September) - abstract here) They took three groups; Advice and exercise (n=116), advice and exercise plus true acupuncture (n=117), and advice and exercise plus non-penetrating acupuncture (n=119). Have a look at the abstract for the details, the whole article is behind a paywall. The conclusions are as follows:

The addition of acupuncture to a course of advice and exercise for osteoarthritis of the knee delivered by physiotherapists provided no additional improvement in pain scores. Small benefits in pain intensity and unpleasantness were observed in both acupuncture groups, making it unlikely that this was due to acupuncture needling effects.

Strike 3 - out?


  1. Icorrect paper.
    These results can appeared only due to NON-COMPETENCE OF AUTHORS IN ACUPUNCTURE! Or unsufficient competence.
    That is why - the paper presents almost the same data (%) both in real acupuncture and in sham acupuncture!
    Read the paper attentively.
    You are discussing here THE INCORRECT DATA.
    And no more.
    Certainly, the fight against pseudoscience is important thing!
    But it is necessary to do it using your reason, sense, mind, brain! it is necesary to think by own head, but not parrot the words of other people (even if it is clever people!).

  2. Thanks for your comment, Pepper, although I'm not sure I understand what you mean!

    From what I can understand the acupuncture was carried out by acupuncturers (ists?) so any incompetence is on their part, not the authors?

    For a fuller rebuttal, I would be grateful if you could provide more definitive points rather than general accusations!


  3. I mean the paper of German authors, which was discussed with such wild delight in Ben Goldacre's blog and DC's blog:
    There is the link for full text of this paper in Ben's blog. If the link doesn't work and you haven't this paper, then ask me (sp_ dot inbox dot com) or David Colquhoun.