MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

The medical literature is currently swamped with reviews of acupuncture (and other forms of TCM) trials originating from China. Here is the latest example (but, trust me, there are hundreds more of the same ilk).

The aim of this review was to evaluate the effectiveness of scalp, tongue, and Jin’s 3-needle acupuncture for the improvement of post-apoplectic aphasia. PubMed, Cochrane, Embase databases were searched using index words to identify qualifying randomized controlled trials (RCTs). Meta-analyses of odds ratios (OR) or standardized mean differences (SMD) were performed to evaluate the outcomes between investigational (scalp / tongue / Jin’s 3-needle acupuncture) and control (traditional acupuncture; TA and/or rehabilitation training; RT) groups.

Thirty-two RCTs (1310 participants in investigational group and 1270 in control group) were included. Compared to TA, (OR 3.05 [95% CI: 1.77, 5.28]; p<0.00001), tongue acupuncture (OR 3.49 [1.99, 6.11]; p<0.00001), and Jin’s 3-needle therapy (OR 2.47 [1.10, 5.53]; p = 0.03) had significantly better total effective rate. Compared to RT, scalp acupuncture (OR 4.24 [95% CI: 1.68, 10.74]; p = 0.002) and scalp acupuncture with tongue acupuncture (OR 7.36 [3.33, 16.23]; p<0.00001) had significantly better total effective rate. In comparison with TA/RT, scalp acupuncture, tongue acupuncture, scalp acupuncture with tongue acupuncture, and Jin’s three-needling significantly improved ABC, oral expression, comprehension, writing and reading scores.

The authors concluded that compared to traditional acupuncture and/or rehabilitation training, scalp acupuncture, tongue acupuncture, and Jin’ 3-needle acupuncture can better improve post-apoplectic aphasia as depicted by the total effective rate, the ABC score, and comprehension, oral expression, repetition, denomination, reading and writing scores. However, quality of the included studies was inadequate and therefore further high-quality studies with lager samples and longer follow-up times and with patient outcomes are necessary to verify the results presented herein. In future studies, researchers should also explore the efficacy and differences between scalp acupuncture, tongue acupuncture and Jin’s 3-needling in the treatment of post-apoplectic aphasia.

I’ll be frank: I find it hard to believe that sticking needles in a patient’s tongue restores her ability to speak. What is more, I do not believe a word of this review and its conclusion. And now I better explain why.

  • All the primary studies originate from China, and we have often discussed how untrustworthy such studies are.
  • All the primary studies were published in Chinese and cannot therefore be checked by most readers of the review.
  • The review authors fail to provide the detail about a formal assessment of the rigour of the included studies; they merely state that their methodological quality was low.
  • Only 6 of the 32 studies can be retrieved at all via the links provided in the articles.
  • As far as I can find out, some studies do not even exist at all.
  • Many of the studies compare acupuncture to unproven therapies such as bloodletting.
  • Many do not control for placebo effects.
  • Not one of the 32 studies reports findings that are remotely convincing.

I conclude that such reviews are little more than pseudo-scientific propaganda. They seem aim at promoting acupuncture in the West and thus serve the interest of the People’s Republic of China. They pollute our medical literature and undermine the trust in science.

I seriously ask myself, are the editors and reviewers all fast asleep?

The journal ‘BMC Complement Altern Med‘  has, in its 18 years of existence, published almost 4 000 Medline-listed papers. They currently charge £1690 for handling one paper. This would amount to about £6.5 million! But BMC are not alone; as I have pointed out repeatedly, EBCAM is arguably even worse.

And this is, in my view, the real scandal. We are being led up the garden path by people who make a very tidy profit doing so. BMC (and EBCAM) must put an end to this nonsense. Alternatively, PubMed should de-list these publications.

This has been going on for far too long; urgent action is required!

 

11 Responses to The scandal of Chinese acupuncture research and its publication in seemingly reputable journals

  • pity I cannot paste this cartoon regarding tongue acupuncture, but here is the link: https://www.glasbergen.com/wp-content/gallery/weightloss/diet124.gif

  • Hmmm, maybe you can actually do something about it as you are listed as an ‘editorial advisor’ on the board of BMC Complement Altern Med. https://bmccomplementalternmed.biomedcentral.com/about/editorial-board

    • great!
      I did not know this – or had forgotten; I will send a letter.

      • I was quite curious if you were aware of this – nowadays these open access journals (or predatory journals) simply put names on their editorial boards without people knowing about it. Not even to mention ‘predatory’ conferences etc. I think you did write a post about this in the past

        • yes I did, but in this case, I may also just have forgotten
          – at one stage of my career, I accepted most of such invitations and ended up on the ed board of mist SCAM journals.

        • I have just emailed this complaint:
          Dear Mrs Menard,
          I am writing as a member of the Ed-board of this journal to complain about this paper:
          https://www.ncbi.nlm.nih.gov/pubmed/31653216
          My main criticisms are as follows:

          All the primary studies were published in Chinese and cannot therefore be checked by most readers of the review.
          The review authors fail to provide the detail about a formal assessment of the rigour of the included studies; they merely state that their methodological quality was low.
          Only 6 of the 32 studies can be retrieved at all via the links provided in the articles.
          As far as I can find out, some studies do not even exist at all.
          Many of the studies compare acupuncture to unproven therapies such as bloodletting.
          Many do not control for placebo effects.
          Not one of the 32 studies reports findings that are remotely convincing.
          None of the limitations are discussed in the paper or its conclusions.
          The conclusions are not warranted and mislead the public.

          Please acknowledge receiving this email and let me know what you intend to do.
          Best regards
          Edzard Ernst

  • When reading the abstract being discussed here, this appeared in the “Similar articles” vignette on the PubMed site: https://www.ncbi.nlm.nih.gov/pubmed/31001680

    Did the Professor refer to this article in ‘Wiener klinische Wochenschrift’ before, here on this blog? I have a vague recollection of having seen something about it before. I presume the word “Wiener” refers to the well known Austrian metropolis, not a type of popular sausage? This reference in the name ought to give the journal a modicum of respectability, but one undeniably begins to have doubts.
    At first glance this looks like another fake review of / review of fake research?

  • IF you are seriously interested in “science,” perhaps you should encourage PubMed to de-list any medical journal that accepts drug advertising. It is a long-known fact that advertisers influence what a magazine publishes (and doesn’t publish). Such sources of money influence what is and what isn’t published. When authors pay to get their article published, at least there’s no influence from drug companies.

    • if memory does not fail me, the homeopathic journals also have ads.
      “advertisers influence what a magazine publishes”. aren’t you confusing this with sponsors of studies? can you show us the evidence, please?

    • Dana

      You make a superficially valid point, but journals are not the same as magazines.

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