MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

Acupuncture is little more than a theatrical placebo! If we confront an acupuncture fan with this statement, he/she is bound to argue that there are some indications for which the evidence is soundly positive. One of these conditions, they would claim, is nausea and vomiting. But how strong are these data? A new study sheds some light on this question.

The objective of this RCT was to evaluate if consumption of antiemetics and eating capacity differed between patients receiving verum acupuncture, sham acupuncture, or standard care only during radiotherapy. Patients were randomized to verum (n = 100) or sham (n = 100) acupuncture (telescopic blunt sham needle) (12 sessions) and registered daily their consumption of antiemetics and eating capacity. A standard care group (n = 62) received standard care only.

The results show that more patients in the verum and the sham acupuncture group did not need any antiemetic medications, as compared to the standard care group after receiving 27 Gray dose of radiotherapy. More patients in the verum and the sham acupuncture group were capable of eating as usual, compared to the standard care group. Patients receiving acupuncture had lower consumption of antiemetics and better eating capacity than patients receiving standard antiemetic care, plausible by nonspecific effects of the extra care during acupuncture.

The authors concluded that patients receiving acupuncture had lower consumption of antiemetics and better eating capacity than patients receiving standard antiemetic care, plausible by nonspecific effects of the extra care during acupuncture.

I find these conclusions odd because they seem to state that acupuncture was more effective than standard care. Subsequently – almost as an afterthought – they mention that its effects are brought about by nonspecific effects. This is grossly misleading, in my view.

The study was designed as a comparison between real and sham acupuncture, and the standard care group was not a randomised comparison group. Therefore, the main result and conclusion has to focus on the comparison between verum and sham acupuncture. This comparison shows that the two did not produce different result. Therefore, the study shows that acupuncture was not effective.

A much more reasonable conclusion would have been: THIS STUDY FAILED TO FIND SIGNIFICANT EFFECTS OF ACUPUNCTURE BEYOND PLACEBO.

59 Responses to Acupuncture: an interesting new study with negative results and odd conclusions

  • I agree that this is an interesting RCT. I also think that it is a very well conducted study with relevance for the Cochrane review on the P6 acupoint by Lee et al 2015 which found stimulation of this point by a variety of methods was significant compared with sham. The quality of the trials was a concern, however, with only 2 out of 59 trials classed as having low risk of bias.

    I must give credit to the authors of this new trial for their final statement:

    “Since nonspecific antiemetic treatment effects during the needling caring situation seem to have achieved the fact that both patients receiving verum and sham acupuncture needed less antiemetics and had larger capacity to eat compared to patients receiving standard care, further studies should evaluate the effect of contextual caring factors for strengthening the quality of care and reducing side-effects such as emesis during cancer therapy.”

    For once I will take issue with you Edzard. I think you are being too severe.

    Of current relevance to another acupuncture thread on your blog here, another quote:

    “Other strengths of the study are the sham-controlled design using the nonpenetrating sham needle which is as both credible and inert as possible. Of course the telescopic sham needle touched the skin during the few seconds for placing and manipulating the sham needles every needling session. However, the sensorimotor activation of a variety of brain regions was clearly lower during sham needling as compared to during verum acupuncture needling”

    Non-puncturing and measurably lower pressure had exactly the same effect as acupuncture at the same acupuncture point. And all down to non-specific factors of treatment, aka placebo effects.

    • what precisely do you take issue with:
      “I find these conclusions odd because they seem to state that acupuncture was more effective than standard care. Subsequently – almost as an afterthought – they mention that its effects are brought about by nonspecific effects. This is grossly misleading, in my view.
      The study was designed as a comparison between real and sham acupuncture, and the standard care group was not a randomised comparison group. Therefore, the main result and conclusion has to focus on the comparison between verum and sham acupuncture. This comparison shows that the two did not produce different result. Therefore, the study shows that acupuncture was not effective.
      A much more reasonable conclusion would have been: THIS STUDY FAILED TO FIND SIGNIFICANT EFFECTS OF ACUPUNCTURE BEYOND PLACEBO.”

      • The study states that the difference between acupuncture and standard care can be explained by non-specific factors. On the basis of what they consider to be a credible sham producing precisely the same benefits as acupuncture.

        For me this is a refreshing change from what we normally see. Which is to claim the benefits of acupuncture by disclaiming the validity of sham. This is egregious, however, since if the sham is not for purpose then whatever benefits there might appear to be could be due to non-specific factors.

      • I regret I was too hasty. I went straight to the meat of the study without first reading the title. Big mistake.

        “Reduced Need for Rescue Antiemetics and Improved Capacity to Eat in Patients Receiving Acupuncture Compared to Patients Receiving Sham Acupuncture or Standard Care during Radiotherapy”

        That title simply does not fit with what comes below it. Is there a misprint?

        Also the trial did not carry out a power calculation for the intended objectives which adds to your point about non-randomisation of the standard treatment arm; and yes, I do agree that the conclusion should have clearly expressed that no difference was found between acupuncture and sham.

      • “The study was designed as a comparison between real and sham acupuncture, and the standard care group was not a randomised comparison group.”

        And presumably subjects will have been able to tell that they were in the acupuncture group, whether real or sham, rather than the standard care group, so as far as comparing acupuncture (real or sham) with standard care goes it was also unblinded?

        • It’s true that those receiving neither acupuncture nor sham cannot be ignorant of the fact. However, one unfortunate consequence of being randomised to receive standard care is disappointment leading to a negative placebo effect: “nocebo” effect.

    • Edzard

      “However, the sensorimotor activation of a variety of brain regions was clearly lower during sham needling as compared to during verum acupuncture needling”

      Wouldn’t that just show that “activating a variety of brain regions” isn’t how acupuncture would have an effect? Wouldn’t it be a better sham if non-points were used – and rule out any other potential mechanisms? From a total layman point of view, it would seem that needling non-points (to see the effect on the ‘brain regions’, as well as the results) and using the non-puncturing needles on non-points would give a better picture. Or has that been done?

      • I am sure it has been done.
        if I remember correctly, acupuncturists argue against this method [but I forgot why].

      • What it shows is that significantly less pressure was brought to bear by the blunt sham needle than was the case for the acupuncture needle. So neither puncture nor pressure was the cause of the benefits.

      • Wouldn’t it be a better sham if non-points were used…

        How would the needler locate and identify a “non-point”. If I remember right, someone collated about 200 different varieties of acupuncture-systems, which of course all work admirably according to their respective proponents. It was apparently found that there is hardly a spot on the human body that is not defined in one or more of these systems. Except of course the male genitals, for some peculiar reason? Can’t find that reference just now.

        Even the acupuncturists themselves seem confused.
        Mark Crislip listed all the different varieties of acupuncture he could find.
        The infinite variety of the world of needling is mind boggling.

        So, which acupuncture system should be used for research and how to ensure not hitting a point useful in any of the myriad of methods?

        • It doesn’t matter where the needles are placed for the purposes of clinical trials. Allow acupuncturists to specify APs and non-APs howsoever they wish to do so. What results in well conducted trials?

          No difference.

          Then shams are declared not to be shams and all points are accepted as legitimate – advocates declare this to be scientific acupuncture; meridians are transmuted into nerves and notions of Chi etc. are abandoned.

          Unfortunately acupuncture is rendered unfalsifiable. No shams allowed, remember.

          So, not science then.

        • Bjorn

          To add to the confusion of this particular experiment, it seems that 2 points were used (bilateral neiguan), and the needling was done by physiotherapists. With the results they got from that…it would seem that a study of an acupuncture treatment, performed by trained acupuncturists would be worth doing.

          Also a study of antiemetics. Yikes.

          • All those many thousands of physiotherapists trained in acupuncture are not truly trained in acupuncture?

            lol

            As an aside, as I was waiting at some traffic lights in a London suburb yesterday, I noticed one of the one-stop-cam-shops which are so prevalent these days – there’s one virtually on my own doorstep. lol

            What was being sold? Chiro. Osteo. Acu. Physio. The holy quartet, as t’were.

            The thought that immediately struck me was: the laying on of hands – four varieties of.

            Treatments offering personal time and attention and the laying on of hands as unifying themes.

            These must constitute powerful placebo components, don’t you think?

            Shoppers might try them all on for size, and perhaps find that one fits them better than the others; or depending on their mood use them all as and when. That choice element might also feed into the placebo effect. Many subtle things must contribute. That is why it is so important to have an effective placebo control to distinguish specific from non-specific effects.

            Credit to the physiotherapists who performed this trial for recognising this fact; endeavouring to control for it as best they could; and acknowledging that their results are most likely placebo effects.

          • Uh-oh! Seems like ‘no true acupuncturist’ needs to join ‘no true chiropractor’ and ‘no true homeopath’. Is there any consistent rationale behind any form of altmed?

          • All those thousands of physiotherapists may in fact have some training in acupuncture. And, the bilateral pc6 thing is pretty straightforward, points are easy to find, and acupuncturists will sometimes teach patients how to locate it and how to stimulate it with non-puncturing needles for home care.

            Even though the point of the study may not have been effectiveness of treatment, with those results it would seem useful to do an effectiveness study. If sham and needles perform similarly, and outperform standard care, it would be quite useful for home treatment. Or to see a physio, MD, chiro, a neighbor, pretty much anyone for the treatment. Possibly a better treatment, while avoiding the risks and costs of antiemetics.

          • Edzard accurately reported the stated objective of the study:

            “to evaluate if consumption of antiemetics and eating capacity differed between patients receiving verum acupuncture, sham acupuncture, or standard care only during radiotherapy”

            No difference in effects between sham and acupuncture were found. Those effects compared to standard care were therefore judged to be placebo effects.

            This was an effectiveness study.

            The authors concluded that the intricacies of the placebo effect should be studied to see if useful lessons for treating patients could be learned. It wasn’t acupuncture per se that produced the benefits. It could be useful to know what those common aspects of acupuncture and sham – other than acupuncture per se – produced the benefits compared with standard treatment.

            Those aspects might possibly be applied directly to patients without the costs and risks of both antiemetics and acupuncture. Perhaps it was literally the human touch? Perhaps antiemetics and needles are not required? Or perhaps it was the patients’ hopes or expectations of benefit from a new treatment that did the trick? In which case one might consider offering sham acupuncture to obtain the benefits without the risks of acupuncture. This would entail doubly deliberate deception, though. It’s not actually acupuncture and if it was, it isn’t that which provides the benefit. It’s patients’ psychology.

            I’m not clear what your position is on physiotherapists trained in acupuncture.

            Do you trust physiotherapists trained in acupuncture to perform acupuncture or not?

            There are acupuncturists in China who believe that acupuncturists outside China are not true acupuncturists, because trials conducted outside China sometimes obtain negative results. This, they say, cannot happen if acupuncture is performed correctly.

            Who decides who is or is not qualified to give acupuncture? Physiotherapists presumably must be sanctioned by an acupuncture authority?

          • Leigh

            Edzard is saying that the study was designed as a comparison between real and sham acupuncture, and the standard care group was not a randomised comparison group. I was saying that it would be good to do a study designed to compare acupuncture/sham to standard care.

            “Who decides who is or is not qualified to give acupuncture? Physiotherapists presumably must be sanctioned by an acupuncture authority?” In the US, it varies state to state. State laws determine who can legally put a needle in someone else. I have no idea what the laws are elsewhere.

            “I’m not clear what your position is on physiotherapists trained in acupuncture.”
            I don’t have one. I’ve learned the hard way that licensure has little to do with anything other than state laws.

            But if the goal of a study is to study the effectiveness of needling specific points, use acupuncturists. They do a lot of that.

            Lots of folks (even some acupuncturists) are trained to perform the Epley maneuver. If you want to study the effectiveness of the Epley maneuver, have PTs perform it – not an acupuncturist. PTs (in my town anyway) are the ones who perform that maneuver a lot.

            If that doesn’t make sense to you, we’ll leave it at that. No use discussing it more.

            “Do you trust physiotherapists trained in acupuncture to perform acupuncture or not?”

            That’s a meaningless question. Based on your other comments, I get the sense that you confuse putting needles in certain points with an acupuncture treatment (needling is one of many tools that an acupuncturist could use in a treatment session). So by ‘acupuncture’ I’m going to assume you mean putting needles into the body.

            It’s impossible to tell (just because they were trained to put a needle in someone) if they are good at it. I know MDs that shouldn’t be allowed anywhere near a patient with a needle. And I know an MD that is more skillful with a hypodermic than most acupuncturists with a filiform. My dentist is fantastic with a needle, and so is my martial arts teacher.

            Sure, I’d trust a PT to put a needle in neiguan. That point is pretty easy to find, pretty easy to needle, and the interior space you’re targeting is relatively hard to miss. You don’t even have to be that accurate to have some kind of effect – some general tapping with a finger over that point can affect the body. Pressuring the point with a non-puncturing needle would be good, too (and easy to teach patients to use for home treatment).

            But if you were trying to minimize variables for a study, have an acupuncturist do it.

          • “But if the goal of a study is to study the effectiveness of needling specific points, use acupuncturists.”

            That’s just the question. Who decides who is a legit acupuncturist? You? Me? Some PTs may do a lot of acupuncture. Could it be that an “acupuncturist” is self-defining? I am one if I say I am one. And other denying: You are not qualified if I say you are not.

            Perhaps you agree with those acupuncturists in China who say that acupuncture trials can never be negative if practiced properly? Meaning all the trials outside China which have found acupuncture to have no greater benefit than placebo must necessarily have failed to perform acupuncture properly – as you suggest may be the case in the trial under discussion here?

            As for me, I think this trial is not top quality but there’s a lot, lot worse acupuncture trials out there. Lots and lots and lots.

          • “there’s a lot, lot worse acupuncture trials out there. Lots and lots and lots.”
            VERY TRUE!

          • Leigh,

            Where do you live? In most (if not all, by now) US states, acupuncturists are licensed. You can google it. Again, if you can’t understand why you would use an acupuncturist to perform the treatments for a study…there’s no use discussing it.

            As for the “Perhaps…here?” paragraph – I’m not implying that at all. Just the opposite. Again, if the treatments done in that study outperformed standard care, shouldn’t standard care be replaced by sham needling to bilateral neiguan? Cheaper, safer, more effective, and can be done by anyone.

            Edzard is saying that the study was designed as a comparison between real and sham acupuncture, and the standard care group was not a randomised comparison group. I was saying that it would be good to do a study designed to compare acupuncture/sham to standard care. But I guess we could forget about the acupuncture part and just compare sham acupuncture to standard care. Why keep using antiemetics if non-puncturing needles to neiguan is more effective?

          • Edzard

            You’re saying that it’s not a good trial for comparison to standard care. Wouldn’t these results suggest that it would be worth doing a study comparing sham acu to standard care? More benefit, way less risk.

          • no; are you trying to put words in my mouth?

          • What words am I trying to put in your mouth? These are your words:

            “The study was designed as a comparison between real and sham acupuncture, and the standard care group was not a randomised comparison group. Therefore, the main result and conclusion has to focus on the comparison between verum and sham acupuncture. This comparison shows that the two did not produce different result. Therefore, the study shows that acupuncture was not effective.”

            Great. So why not randomise the comparison group and compare sham acupuncture to standard care? Sham acupuncture would have almost no risk.

          • for doing such a trial, I would want to make sure that whatever I am testing against standard care is better than a placebo. thus sham-controlled studies need to come first, in my view.

          • That seems like an easy thing to do. Instead of calling it “sham acupuncture”, give it some fancy name that describes using non-puncturing needles. You could use the Latin for ‘needle’ (that always makes it sound good), and add it to ‘pressure’ or something that indicates the needle isn’t puncturing. Use the new-named thing on neiguan. Use non-puncturing needles somewhere else on the body.

          • easy? really? why don’t you do it then?

          • @jm

            Replaced by sham needling?

            Yes, but it would have to be honestly done.

            A trial would need to be done comparing deceptive sham – where subjects believe themselves to be receiving acupuncture – against a group receiving honest sham – they know that they are not receiving acupuncture.

            I would be very surprised if the placebo benefits did not vanish in the honest sham group in a rigorously conducted trial.

          • I’m not in the business of prescribing antiemetics. If I were, and there was a hint at a more effective, risk free, cheaper alternative that patients could do at home – this certainly would seem to be worth the effort of looking into.

          • Leigh

            Why would you have a group where subjects believe themselves to be receiving acupuncture? No need for needle puncturing. And why would you not do it honestly? Compare needle pressure with standard care with no care.

          • Several years ago, after the famous toothpick v acupuncture RCT, which showed no difference between the two, I realised that the absolute RCT clincher would be an honest sham v a deceptive sham. If the placebo benefits of a deceptive sham do not vanish with an honest sham then I shall disappear in a puff of insanity.

            The problem is the ethics of such a trial.

            The trial would have to convince patients that they are participating in a comparison between genuine acupuncture v honest sham. This could be explained by telling patients that it is known that sham is as good as acupuncture when trial subjects do not know what they are receiving, and it would be helpful to find out what happens when patients do know what they are receiving. One group would need to be told (falsely) that they were receiving acupuncture, whilst the other group would be shown that sham needles were merely being placed against their skin.

            The problem is that such a trial would be one giant sham. Patients would have been lead to believe that there was a 50% chance of receiving acupuncture when in fact there was no chance at all.

            I can’t see how an ethics board could allow it. One possible way of trying to obtain permission would be to tell patients that those randomised to sham would receive acupuncture at the end of the trial, and then at the end of the trial tell the duped acupuncture group that they too could now receive genuine acupuncture. However, it’s not difficult to imagine some very angry responses to having been lied to.

            I’m afraid the clincher experiment is never going to happen.

          • “Why would you have a group where subjects believe themselves to be receiving acupuncture?”

            Because I am talking about acu-PUNCTURE. You may define acupuncture to be a form of acupressure, but that is not how it is generally perceived. The average person thinks acupuncture is sticking needles into the body. That’s what they expect if they go along to try it and that is what they generally get. I assume. That’s what I would expect. If they or I go along for a session of acupressure that’s another story.

          • “You may define acupuncture to be a form of acupressure,”
            No, and I don’t know how you come to that conclusion. Acupressure is pressuring an acupuncture point, sometimes with a blunted needle that doesn’t pierce the skin (probably how it got named ‘acu’/needle – pressure, eh?). They are different tools.

            You don’t seem to be understanding this, but here it is again. If you go to see an LAc (licensed acupuncturist) – you may or may not get punctured by needles. Needling is one of many tools they use. It’s their specialty, so more than likely you’ll get needled. But not necessarily. It depends on what’s going on – you might receive gua sha, cupping, tuina, external herbs, internal herbs. They might adjust your diet, your daily habits, they might give you some exercises or qigong to practice. Depends. Most likely, you’ll get a combo of some of them. The acupuncturist will explain all of this in person.

            Most people shorthand “I’m going to see my Licensed Acupuncturist” to “I’m going for acupuncture”. Even if they know they’ll probably receive more than needling.

            The average person probably does expect needles. The average person also probably expects to leave their MD’s office with a prescription. They probably expect to leave the PT’s office with some exercises to do.

            If they go for an acupressure treatment, they might expect the practitioner to hold finger pressure on acupuncture points for a period of time. But acupressure will also use external herbs, some other forms of massage, cupping, various blunted instruments used on points, self-care homework, etc. Depends.

            As far as the antiemetics – forget about acupuncture. The insertion of needles and pressuring with needles gave pretty much the same results. In the study Edzard is referencing, they both did better than standard care. So let’s take puncturing with needles out of the picture. Plus, you can’t do that at home.

            If I was in the business of treating the side effects from radiotherapy, I would like to see the results from comparing standard care to non-puncturing needles on the specific points on the wrist. It’s safer, easier, and cheaper. It can be done at home, by anybody.

            And, the study Edzard references didn’t study a treatment from an acupuncturist (LAc) – it looked at needling some points that would probably be used in a full treatment (that could involve herbs, massage, etc). But shorthanding that to ‘acupuncture’ is easier, if we all know we’re talking about needling some points rathe than a full treatment from an acupuncturist. That’s not a “it wasn’t real acupuncture” comment, it’s a “great, you can easily do this at home” statement.

            Same with the toothpick study you were talking about (if you’re talking about the LBP one). The LBP/toothpick study – toothpicks & needles both performed significantly better than the other treatments in the study (1 ½ times, I think). If you went to an LAc for low back pain, it would be strange to receive a treatment that only included needles to a series of points. The surprising thing about that study was how much of a role manipulating the specific points played. I would have guessed the point work played a smaller role. (Same with the antiemetic thing – I would have thought that stimulation of bilateral neiguan would have played a smaller role. Who knew?)

            But, if you get better results than standard care using toothpicks to specific points…that’s fantastic! Other than splinters, there’s no risk. You can do it at home (with a bit of training to find the points) for free. Any time you don’t have to get in a car, bus, etc to travel to a treatment (particularly for low back pain, or nausea), that’s quite the bonus.

            Sorry for the long comment – I’m a bit short on time today.

          • jm,

            The average person also probably expects to leave their MD’s office with a prescription.

            Citation needed!

            You don’t seem to be understanding this, but here it is again. If you go to see an LAc (licensed acupuncturist) – you may or may not get punctured by needles. Needling is one of many tools they use. It’s their specialty, so more than likely you’ll get needled. But not necessarily. It depends on what’s going on – you might receive gua sha, cupping, tuina, external herbs, internal herbs. They might adjust your diet, your daily habits, they might give you some exercises or qigong to practice. Depends. Most likely, you’ll get a combo of some of them. The acupuncturist will explain all of this in person.

            You don’t seem to be understanding this, but here it is again: Is going to see a licensed acupuncturist better than, the same as, or worse than going to see a licensed: Alexander Technique practitioner; Applied Kinesiology practitioner; aromatherapist; chiropractor; homeopath; naturopath; osteopath; Reiki practitioner; yoga instructor; et al.?

            I’m very interested in your opinion, provided that you can produce evidence to support it. Licensed camists who are unable to provide an evidence-based answer to my question are, by definition, unable to obtain adequately informed consent from their patients. Such practitioners are simply practising license without a medicine.

          • Cherkin et al. found that toothpicks disguised as acupuncture needles, and individualised and standardised acupuncture, equally effective and better than usual care – on acupuncture naive patients. IOW, which acupoints or whether needles were inserted didn’t matter. They concluded that either superficial needle contact at any acupoint or placebo effects were possible explanations for the results.

            My proposed trial is designed to test what causes the difference between acupuncture/sham and standard care. (A standard care group would not be strictly necessary for the purpose of my trial but could add weight to the difference found between treatments and standard care in other trials.)

            Your proposed trial leaves that question unanswered. It’s only to be expected that acupressure would elicit greater placebo effects from patients happy to be receiving treatment over and above standard care. It would not be right to provide acupressure without antiemetics unless patients did not want them. I suspect not too many would refuse all use of them.

            Your trial would be of very little value IMO.

          • Leigh –

            “They concluded that either superficial needle contact at any acupoint or placebo effects were possible explanations for the results.”

            You should do the trial. In the meantime, LBP patients should be told that toothpicks are their best bet. If superficial needle contact at any acupoint or placebo effects is outperforming standard care…it would seem that standard care could use a tune up.

            Pete – ???

          • My trial is only ever going to be a thought experiment.

            Don’t bother doing yours, it would prove nothing.

            There’s good evidence that where needles are placed is irrelevant. The GERAC trials, for example. And why bother with needles at all if blunt pressure does the trick?

            I’ve no objections to people pressing random points on their bodies to see if it does them any good.

            Everybody is free to try that experiment for themselves. 🙂

        • “And why bother with needles at all if blunt pressure does the trick?”

          That’s exactly what I was saying, Leigh. And, if blunt pressure outperforms standard care, how could an MD ethically still recommend standard care? Or maybe they don’t anymore?

          And, not only are people free to try that experiment on themselves…some actually do. It’s amazing how often the timing of a simple home treatment corresponds with a spontaneous lessening of symptoms. It’s weird how consistent coincidence can be, eh? 🙂

          • Your last statement shows you have little, if any, understanding of placebo effects, e.g. regression to the mean.

            The fact that standard treatment can be beaten by what is virtually certain to be placebo effects show that certain conditions have no good treatment to offer. It’s difficult for doctors to tell their patients this. But certainly if doctors are going to offer placebos self-administered poking around would be the one of choice. Of course there are ethical questions about offering placebos to patients.

          • “The fact that standard treatment can be beaten by what is virtually certain to be placebo effects show that certain conditions have no good treatment to offer.”
            That fact is hopefully being told to patients, by their doctors. Before offering up treatments that seem to be less effective and definitely carry more risk. Unless the patient is allergic to wood, of course.

            “It’s difficult for doctors to tell their patients this.”
            Why would it be difficult for doctors to tell their patients about the findings from a study? Medicine changes all the time, based on new information. That’s been true forever.

            “Of course there are ethical questions about offering placebos to patients.”
            Yes, the ethical question is why would doctors recommend standard treatment when there seem to be safer, more effective, options.

          • “That fact is hopefully being told to patients”

            I would hope so too though I am not entirely sure that everybody would agree. It’s some years ago now, but a poll found that many doctors admitted to prescribing placebos. Presumably they would not do so if they believed a patient had an unimaginary ailment for which there was an effective treatment.

            Why might they do that? One may speculate.

            “why would doctors recommend standard treatment when there seem to be safer, more effective, options”

            I am not aware that there is any evidence that this is happening intentionally.

          • Good to hear.

    • I don’t think Prof. Ernst is too tough. The study is titled: “Reduced Need for Rescue Antiemetics and Improved Capacity to Eat in Patients Receiving Acupuncture Compared to Patients Receiving Sham Acupuncture or Standard Care during Radiotherapy”

      This is clearly not what the study demonstrates.

      • I noticed this only after returning to read the study a second time following Edzard’s prompting. The title immediately struck me the same way as it did you.

        However, on further consideration, it is possible that the title refers to the objective of the trial rather than the result. In which case it’s most unfortunate; careless even.

        • Well, a trial does not have an objective. If the title would refer to the scientific question asked, it would have been phrased as exactly that, a question.

  • This website and its author are clearly biased with the information and selective content that it promotes. Just like scientists making sure never to bite the hand that feeds you the same can be found spread heavily amongst these pages. To say that certain traditional therapies don’t work is a disrespectful poke in the face of all those billions of people who have found such therapies do work and have indeed provided natural healing and pain relief over many thousands of years. Surely every single one of these people can’t be wrong or it be some mind trick or mass delusion.To suggest that would be ludicrous. Shame on this site for misleading peoples minds with half truths and so called paid for science which from the outset seeks to undermine anything natural and Traditional and push people further into using Western Medicine and it’s drug based therapies.

    To take synthetic pills derived from the petrochemical industry for the the rest of your life whilst suffering a number of negative side effects which ultimately make you sicker can hardly be considered a cure or healing or good therapy or good medicine. Come on who’s being deceived here.

    If two thirds of the world’s population use acupuncture and say it does work, has worked and continues to work for them why not report on that.

    • have you heard about a fallacy called ARGUMENTUM AD POPULUM?
      perhaps you should read up about it!
      have you heard of such phenomena as regression towards the mean, natural history of the disease, placebo effect?
      obviously not!

      • Arguments Ad Populum is precisely how the Modern medical scientific industry and this website work. Get the majority of the population believing in a lie and then everyone else who prefers to stick with the truth gets labelled quacks or quackery

        I support totellyms comments. Western Medicine seeks not to cure disease but to manage the symptoms of disease with long term drug use and long term profits.

        We all know this to be true but according to the herd mentality we pretend otherwise.

        • oh dear!
          I am not sure how the ‘modern medical scientific industry’ works – but I know how this website [actually, it’s a blog] works, and it is not by getting ‘the majority of the population believing in a lie and then everyone else who prefers to stick with the truth gets labelled quacks or quackery’. here we try to discuss evidence where possible.

          • Hey I can appreciate your comments protecting your beliefs and those of majority blog users but you aren’t responding to the statements raised about the ineffectiveness of modern medical synthetic drugs and how they poison people and make them sicker. Infact you have blatantly ignored it. Typical really. I too would ignore it if it meant I had to employ even more smoke and mirrors to counter an argument.

          • absolutely typical!
            you are right.
            my expertise is alt med and I rarely comment on conventional medicine and related issues.

          • I’m sorry but I tend to feel the same, this website is very anti complimentary, natural, traditional medicine. I first hand have seen people give their faith to modern medicine only to get lost to it. Then again I have seen people who refuse to take the toxic drugs and treatments instead preferring a more natural gentle long term approach and make full recoveries.

          • Jeff Bloom said:

            I’m sorry but I tend to feel the same, this website is very anti complimentary, natural, traditional medicine.

            I’m sure Prof Ernst welcomes compliments, but I suspect you may not have read or understood much of what he has written.

            I first hand have seen people give their faith to modern medicine only to get lost to it. Then again I have seen people who refuse to take the toxic drugs and treatments instead preferring a more natural gentle long term approach and make full recoveries.

            Yup. Thanks for confirming my suspicion.

    • For most of human history people have lived in a state of terrible ignorance.

      Emergence from that state has been slow and tortuous.

      We still have some way to go yet.

    • Totellym,

      “If two thirds of the world’s population use acupuncture and say it does work, has worked and continues to work for them why not report on that.”

      Two-thirds of the world’s population does not use acupuncture therefore your antecedent is a false, which renders what follows on from it [the consequent part of your statement] null and void: this is the reason for there being no reports on it.
      https://en.wikipedia.org/wiki/Acupuncture#Adoption

      critical thinking

      The goal of critical thinking is to arrive at the most reasonable beliefs and take the most reasonable actions. We have evolved, however, not to seek the truth, but to survive and reproduce. Critical thinking is an unnatural act. By nature, we’re driven to confirm and defend our current beliefs, even to the point of irrationality. We are prone to reject evidence that conflicts with our beliefs and to attack those who offer such evidence.

      — Professor Robert Todd Carroll, PhD.
      http://skepdic.com/ticriticalthinking.html

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