MD, PhD, FMedSci, FSB, FRCP, FRCPEd

The ACUPUNCTURE NOW FOUNDATION (ANF) have recently published a document that is worth drawing your attention to. But first I should perhaps explain who the ANF are. They state that “The Acupuncture Now Foundation (ANF) was founded in 2014 by a diverse group of people from around the world who were concerned about common misunderstandings regarding acupuncture and wanted to help acupuncture reach its full potential. Our goal is to become recognized as a leader in the collection and dissemination of unbiased and authoritative information about all aspects of the practice of acupuncture.”

This, I have to admit, sounds like music to my ears! So, I studied the document in some detail – and the music quickly turned into musac.

The document which they call a ‘white paper’ promises ‘a review of the research’. Reading even just the very first sentence, my initial enthusiasm turned into bewilderment: “It is now widely accepted across health care disciplines throughout the world that acupuncture can be effective in treating such painful conditions as migraine headaches, and low back, neck and knee pain, as well as a range of painful musculoskeletal conditions.” Any review of research that starts with such a deeply uncritical and overtly promotional statement, must be peculiar (quite apart from the fact that the ANF do not seem to appreciate that back and neck pain are musculoskeletal by nature).

As I read on, my amazement grew into bewilderment. Allow me to present a few further statements from this review (together with a link to the article provided by the ANF in support and a very brief comment by myself) which I found more than a little over-optimistic, far-fetched or plainly wrong:

Male fertility, especially sperm production and motility, has also been shown to improve with acupuncture. In a recent animal study, electro-acupuncture was found to enhance germ cell proliferation. This action is believed to facilitate the recovery of sperm production (spermatogenesis) and may restore normal semen parameters in subfertile patients.

The article supplied as evidence for this statement refers to an animal experiment using a model where sperm are exposed to heat. This has almost no bearing on the clinical situation in humans and does not lend itself to any clinical conclusions regarding the treatment of sub-fertile men.

In a recent meta-analysis, researchers concluded that the efficacy of acupuncture as a stand-alone therapy was comparable to antidepressants in improving clinical response and alleviating symptom severity of major depressive disorder (MDD). Also, acupuncture was superior to antidepressants and waitlist controls in improving both response and symptom severity of post-traumatic stress disorder (PTSD). The incidence of adverse events with acupuncture was significantly lower than antidepressants.

The review provided as evidence is wide open to bias; it was criticised thus: “the authors’ findings did not reflect the evidence presented and limitations in study numbers, sample sizes and study pooling, particularly in some subgroup analyses, suggested that the conclusions are not reliable”. Moreover, we need to know that by no means all reviews of the subject confirm this positive conclusion, for instance, thisthis, or this one; all of the latter reviews are more up-to-date than the one provided by ANF. Crucially, a Cochrane review concluded that “the evidence is inconclusive to allow us to make any recommendations for depression-specific acupuncture”.

“A randomized controlled trial of acupuncture and counseling for patients presenting with depression, after having consulted their general practitioner in primary care, showed that both interventions were associated with significantly reduced depression at three months when compared to usual care alone.”

We have discussed the trial in question on this blog. It follows the infamous ‘A+B versus B’ design which cannot possibly produce a negative result.

Now, please re-read the first paragraph of this post; but be careful not to fall off your chair laughing.

There would be more (much more) to criticise in the ANF report but, I think, these examples are ENOUGH!

Let me finish by quoting from the ANF’s view on the future as cited in their new ‘white paper’: “Looking ahead, it is clear that acupuncture is poised to make significant inroads into conventional medicine. It has the potential to become a part of every hospital’s standard of care and, in fact, this is already starting to take place not only in the U.S., but internationally. The treatment is a cost-effective and safe method of relieving pain in emergency rooms, during in-patient stays and after surgery. It can lessen post-operative nausea, constipation and urinary difficulties, and have a positive impact on conditions like hypertension, anxiety and insomnia…

Driven by popular demand and a growing body of scientific evidence, acupuncture is beginning to be taken seriously by mainstream conventional medicine, which is incorporating it into holistic health programs for the good of patients and the future of health care. In order for this transition to take place most effectively, misunderstandings about acupuncture need to be addressed. We hope this white paper has helped to clarify some of those misunderstandings and encourage anyone with questions to contact the Acupuncture Now Foundation.”

My question is short and simple: IGNORANCE OR FRAUD?

 

6 Responses to Acupuncture: a new ‘white paper’ turns out to be a white-wash (ignorance or fraud?)

  • Ignorance (willfull or otherwise) AND Fraud?

  • I am aware of at least five human clinical trials that support the use of acupuncture in improving male fertility parameters. Of course, ŷou might say that this was another example of placebo in action and that these changes were in the subjects heads, but that’s probably bollocks. Set this in the context of the near absence of drug treatments to help means that this is perhaps the least worst option for couples. Fraud is an inappropriate word to use here. Is Edzard not concerned about the global pharma frauds that have led to a crisis in the world so medicine. For example, the recognition by the editors of major medical journals that a high proportion of the material they have published is bent science created to market pharmaceuticals. Is organised fraud on that scale of no concern to the champions of standards in medical science?

    • Charles buck said:

      I am aware of at least five human clinical trials that support the use of acupuncture in improving male fertility parameters.

      Please feel free to list them.

      Of course, ŷou might say that this was another example of placebo in action and that these changes were in the subjects heads, but that’s probably bollocks.

      Why?

      Set this in the context of the near absence of drug treatments to help means that this is perhaps the least worst option for couples.

      The absense of any ‘drug treatments’ adds nothing to the evidence for acupuncture, does it, and acupuncture is only an option if it is actually effective.

      Fraud is an inappropriate word to use here.

      Why? Do you think it’s ignorance then or maybe sheer incompetence?

      Is Edzard not concerned about the global pharma frauds that have led to a crisis in the world so medicine. For example, the recognition by the editors of major medical journals that a high proportion of the material they have published is bent science created to market pharmaceuticals. Is organised fraud on that scale of no concern to the champions of standards in medical science?

      Irrelevant: Ernst is slagging off homeopathy, yet pharmaceuticals kill 100k a year.

      • Pharmaceuticals do not kill 100k a year, but combined with surgury they save millions, even many of the critical, near terminal patients that are treated at high risk, which are included in the data. How many high risk patients do alts treat? Any abuse or fraud, including some pharma companies should be eliminated. That includes the majority of Alternatives. Risks and benefits should be balanced for any therapy in light of the severity of the condition treated. If a treatment offers no benefit to the patient it should not be offered. If it has a significant risk patients need to be aware of that. Medical care is not as easy as fake medical care.

    • Read an interview of urologist some time ago – he stressed that each man should have his own urologist who would also be able to show simple exercises for improvement of circulation …
      Male fertility is affected by many factors, like obesity, smoking (tobacco, cannabis etc.), sedentary lifestyle, then there are infections that can leave permanent damage (but it does not always mean 100% loss of fertility), genetic diseases (but as long as sperm is produced) …. So all studies should be designed very carefully ….

    • The best thing that ever happened for pharmaceutical companies was anti-depressants. Before they arrived, pharma lived on antibiotics, much of them sold to government at competitive tender prices with little profit. By the nature of things, anti-depressants are mostly sold through private practitioner channels at a healthy profit. Pharma companies give private practitioners huge incentives to prescribe anti-depressants, such as free attendance at the product marketing annual conference, always in exotic locations with the whole family invited. In order to milk the cow as hard as they can, private practitioners prescribe two or more anti-depressants simultaneously, on the spurious grounds that they are complementary. All too often this results in patients walking around in a daze, out of control of their lives.

      I’m not relying on hyped media reports for this accusation. I have several friends who suffered from this very real, highly debilitating condition, and who have weaned themselves off anti-depressants, usually through addiction recovery programs. I worked for a pharma company, on the accounting side it is true, but I have kept up my contacts on the sales and production side.

      When people like Charles Buck talk about the big pharma conspiracy I’m not unsympathetic. Pharma has a good side, an essential side, the creation of drugs to prevent death, extend lifespan and improve physical health. But pharma has contaminated its own image through its creation of the legal high industry. And the methods used, to me, constitute fraud.

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