Tuesday, September 25, 2007

Acupuncture Placebo Effect

The BBC has reported on a German study with some interesting findings.

More than 1,100 patients took part in the study. They were given either conventional therapy, acupuncture or a sham version.

Although needles were used in the sham therapy, they were not inserted as deeply as in standard acupuncture. Neither were they inserted at points thought key to producing a therapeutic effect, or manipulated and rotated once in position.

After six months 47% of patients in the acupuncture group reported a significant improvement in pain symptoms, compared to 44% in the sham group, and just 27% in the group who received conventional therapy.

They go on to pay lip service to Ancient Wisdom and point out that "Acupuncture is based on the ancient Chinese theory that needles can be used to release the body's vital energy, or qi." Of course there's no mention of the fact that there is no such thing as vital energy in any form, qi or otherwise, or that the ancient Chinese "theories" have exactly as much support as medieval belief in humors and bloodletting.

The role of the placebo effect in this study is interesting, and I would love to see it investigated further. In particular, do you get the same 44-47% success rate with needles when the test group believes in acupuncture? How about when they're skeptics? I would imagine that for those who do not accept the whole qi nonsense, the positive effect will shrink dramatically.

This of course raises some ethical concerns for medical professionals. If the placebo effect does in fact help people, but only when they're deluded, then what right do we have to shatter their delusion? Well, the placebo effect can only work some of the time. If your back pain is stress related or in any way psychosomatic, then plain suggestibility might 'cure' you. However, if there's really something physically wrong, then the placebo effect isn't going to help. It's not fair to waste time giving genuinely sick people false treatment just to keep the illusion alive for the hypochondriacs, and further, even when it does help it is dishonest. I may be alone here, but I don't think that giving somebody temporary comfort justifies lying to them for any reason.


Anonymous said...

So how do you explain the fact that either case of acupuncture was at least 75% more effective than conventional treatment.
Is it then good to reason that we should not use it because you think it is due to placebo. should we then instead use the conventional treatment that only succeded to helt 27% of the group instead of something that helps 44-47%?

By the way, you do not mention the fact that even if you do not insert needles in sham as deep as real acupuncture. Well maybe the ones doing the studies ar a little bit short on acupuncture theories.... if the desease is interior, needle deep, if the disease is exterior, needle shallow different people also have different constitution, and should also be needled differently. Something most research do not take into account.

Koddy said...

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