Thursday, September 13, 2012

Yes, Acupuncture Does Work

A little over two weeks ago I responded to an article by skeptic Harriet Hall that misrepresented the current state of research on the effectiveness of acupuncture to what I considered an appalling degree. As it turns out, Hall picked a bad time to launch her tirade - because the latest meta-analysis of acupuncture research, published two days ago in the Archives of Internal Medicine, conclusively shows that acupuncture does in fact work for chronic pain. Notably, this latest study also found a clear difference between traditional acupuncture in which needles are inserted at specific, defined points versus so-called "sham acupuncture," in which needles are inserted at random points in the same general area.

After re-analyzing data from 29 high-quality clinical trials dating back to the 1990s, researchers have concluded that the pain relief derived from acupuncture is partly real, in that it can't be ascribed entirely to the placebo effect.

The trials, which included roughly 18,000 people with chronic pain stemming from arthritis, headaches, or back and neck problems, all compared genuine acupuncture with one of two alternatives: treatment as usual, or "sham" acupuncture -- a counterfeit (i.e. placebo) version of the treatment in which needles are inserted unsystematically.

Pain relief of 50% or more on a 100-point scale -- pain that drops from a 60 to a 30, say -- is a commonly used standard of effectiveness in pain research. By this measure, the study found, the effectiveness rates for real acupunture, sham acupuncture, and treatment as usual are 50%, 43%, and 30%, respectively.

While an argument can be made that some of the benefits of acupuncture are due to the placebo effect - and, as in most medical trials, some of them almost certainly are - a difference of seven percentage points is nonetheless quite significant. Some clinical antidepressants, for example, show less improvement than this versus placebo and nonetheless are fully accepted by the scientific establishment. The problem skeptics have with acupuncture seems to be that nobody has figured out exactly how it works, but it should also be noted that biochemists have yet to work out the exact mechanism behind many antidepressant drugs as well. Either said skeptics just don't have their facts straight, or they're deliberately confusing them to push what I would have to call an anti-science agenda. The whole point of the scientific method is that you don't get to pick and choose only those studies that confirm your personal biases.

Those of us who think that technology may finally be getting to the point where we can empirically verify magical results have to be ready for this. Being a real skeptic means withholding judgment until the data is in and following it wherever it leads, whether it confirms your beliefs or not. Skeptics like Hall, though, seem to think that it means slapping down any scientific result that looks weird, no matter how well the experiment that obtained it was constructed and performed.

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