acupuncture
Menopausal symptoms are a domaine of so-called alternative medicine (SCAM), not least because many women are worried about hormone treatments and therefore want ‘something natural’. TCM practitioners are only too keen to offer their services. But do their treatments really work?
This study aimed to analyze the effectiveness of acupuncture combined with Chinese herbal medicine (CHM) on mood disorder symptoms for menopausal women.
A total of 95 qualified Chinese participants were randomly assigned to one of three groups:
- 31 in the acupuncture combined with CHM group (combined group),
- 32 in the acupuncture combined with CHM placebo group (acupuncture group),
- 32 in the CHM combined with sham acupuncture group (CHM group).
The patients were treated for 8 weeks and followed up for 4 weeks. The data were collected using the Greene Climacteric Scale (GCS), self-rating depression scale (SDS), self-rating anxiety scale (SAS), and safety index.
The three groups each showed significant decreases in the GCS, SDS, and SAS after treatment (p < 0.05). Furthermore, the effect on the GCS total score and the anxiety domain lasted until the follow-up period in the combined group (p < 0.05). Within the three groups, there was no difference in GCS and SAS between the three groups after treatment (p > 0.05). However, the combined group showed significant improvement in the SDS, compared with both the acupuncture group and the CHM group at 8 weeks and 12 weeks (p < 0.05). No obvious abnormal cases were found in any of the safety indexes.
The authors concluded that the results suggest that either acupuncture, or CHM or combined therapy offer safe improvement of mood disorder symptoms for menopausal women. However, the combination therapy was associated with more stable effects in the follow-up period and a superior effect on improving depression symptoms.
Previous reviews have drawn conclusions that are far less positive, e.g.:
- the observed clinical benefit associated with acupuncture may be due, in part, or in whole to nonspecific effects.
- the evidence gathered was not sufficient to affirm the effectiveness of traditional acupuncture compared with sham acupuncture.
- For natural menopause, one large study has shown acupuncture to be superior to self-care alone in reducing the number of hot flushes and improving the quality of life; five small studies have been unable to demonstrate that the effect of acupuncture is limited to any particular points, as traditional theory would suggest; and one study showed acupuncture was superior to blunt needle for flash frequency but not intensity.
- Sham-controlled RCTs fail to show specific effects of acupuncture for control of menopausal hot flushes.
It seems therefore wise to take the conclusions of the new study with a pinch of salt. The intergroup difference observed in this trial may well be due to residual biases, multiple testing, or coincidence. And the reported intragroup differences are in complete accord with the fact that the employed therapies are mere placebos.
This, of course, begs the question of whether SCAM has anything else to offer for women suffering from menopausal symptoms. To answer it, I can refer you to one of our systematic reviews:
Some evidence exists in favour of phytosterols and phytostanols for diminishing LDL and total cholesterol in postmenopausal women. Similarly, regular fiber intake is effective in reducing serum total cholesterol in hypercholesterolemic postmenopausal women. Clinical evidence also exists on the effectiveness of vitamin K, a combination of calcium and vitamin D or a combination of walking with other weight-bearing exercise in reducing bone mineral density loss and the incidence of fractures in postmenopausal women. Black cohosh appears to be effective therapy for relieving menopausal symptoms, primarily hot flashes, in early menopause. Phytoestrogen extracts, including isoflavones and lignans, appear to have only minimal effect on hot flashes but have other positive health effects, e.g. on plasma lipid levels and bone loss. For other commonly used CAMs, e.g. probiotics, prebiotics, acupuncture, homeopathy and DHEA-S, randomized, placebo-controlled trials are scarce and the evidence is unconvincing. More and better RCTs testing the effectiveness of these treatments are needed.
Acupuncture is a panacea, we are often told.
But is it true?
Of course not!
This study was aimed at evaluating the effect of acupuncture on myelosuppression and quality of life in women with breast cancer during treatment with anthracyclines (ANT).
Women with an indication for ANT chemotherapy were randomized into two groups:
- the acupuncture group (AG) was submitted to an acupuncture intervention, starting before the first chemotherapy infusion, and continuing throughout the treatment;
- the control group (CG) received no acupuncture.
A quality of life questionnaire (FACT-G) and peripheral blood levels of the participants were evaluated before and at the end of treatment.
A total of 26 women were randomized into 2 groups: AG (10) and CG (16). Of these, 26.9% had a dense dose indication according to the service’s protocol for the administration of granulocyte-stimulating factor (G-CSF) from the first cycle, not participating in the analysis. The need for secondary prophylaxis with G-CSF occurred in 72.7% in the control group versus 12% in the acupuncture group. Regarding quality of life (QoL), it was observed that the groups did not initially differ from each other. At the end of the treatment, there was a significant difference in the AG for the physical (GP) (p-value=0.011), social/family (GS) (p-value=0.018), and functional (GF) (p-value=0.010) domains, regarding the initial and final FACT-G showed a difference between the groups, where the GA average at the end rose from 80.68 to 90.12 (p-value = 0.004) and in the CG the average dropped from 81.95 to 70.59 (p-value=0.003).
The authors concluded that acupuncture was efficient in the secondary prophylaxis of myelosuppression during chemotherapy and the quality of life of women during treatment has increased.
My interpretation of these results is quite different from that of the authors.
Please let me explain.
The improvement of the quality of life can easily be explained via a placebo effect; acupuncture itself has not necessarily any part in it. But what about the effect on the bone marrow? Might it too be due to a placebo response, or the additional attention? Probably not.
Does that mean that this study proves a definite positive effect of acupuncture?
No!
Why not?
Because firstly the study was far too small for allowing such a far-reaching conclusion, and secondly one would need independent confirmation before accepting such a far-reaching conclusion.
In this retrospective matched-cohort study, Chinese researchers investigated the association of acupuncture treatment for insomnia with the risk of dementia. They collected data from the National Health Insurance Research Database (NHIRD) of Taiwan to analyze the incidence of dementia in patients with insomnia who received acupuncture treatment.
The study included 152,585 patients, selected from the NHIRD, who were newly diagnosed with insomnia between 2000 and 2010. The follow-up period ranged from the index date to the date of dementia diagnosis, date of withdrawal from the insurance program, or December 31, 2013. A 1:1 propensity score method was used to match an equal number of patients (N = 18,782) in the acupuncture and non-acupuncture cohorts. The researchers employed Cox proportional hazards models to evaluate the risk of dementia. The cumulative incidence of dementia in both cohorts was estimated using the Kaplan–Meier method, and the difference between them was assessed through a log-rank test.
Patients with insomnia who received acupuncture treatment were observed to have a lower risk of dementia (adjusted hazard ratio = 0.54, 95% confidence interval = 0.50–0.60) than those who did not undergo acupuncture treatment. The cumulative incidence of dementia was significantly lower in the acupuncture cohort than in the non-acupuncture cohort (log-rank test, p < 0.001).
The researchers concluded that acupuncture treatment significantly reduced or slowed the development of dementia in patients with insomnia.
They could be correct, of course. But, then again, they might not be. Nobody can tell!
As many who are reading these lines know: CORRELATION IS NOT CAUSATION.
But if acupuncture was not the cause for the observed differences, what could it be? After all, the authors used clever statistics to make sure the two groups were comparable!
The problem here is, of course, that they can only make the groups comparable for variables that were measured. These were about 20 parameters mostly related to medication intake and concomitant diseases. This leaves a few hundred potentially relevant variables that were not quantified and could thus not be accounted for.
My bet would be lifestyle: it is conceivable that the acupuncture group had acupuncture because they were generally more health-conscious. Living a relatively healthy life might reduce the dementia risk entirely unrelated to acupuncture. According to Occam’s razor, this explanation is miles more likely that the one about acupuncture.
So, what this study really demonstrates or implies is, I think, this:
- The propensity score method can never be perfect in generating completely comparable groups.
- The JTCM publishes rubbish.
- Correlation is not causation.
- To establish causation in clinical medicine, RCTs are usually the best option.
- Occam’s razor can be useful when interpreting research findings.
This review investigated the characteristics, hotspots, and frontiers of global scientific output in acupuncture research for chronic pain over the past decade. the authors retrieved publications on acupuncture for chronic pain published from 2011 to 2022 from the Science Citation Index Expanded (SCI-expanded) of the Web of Science Core Collection (WoSCC). The co-occurrence relationships of journals/countries/institutions/authors/keywords were performed using VOSviewer V6.1.2, and CiteSpace V1.6.18 analyzed the clustering and burst analysis of keywords and co-cited references.
A total of 1616 articles were retrieved. The results showed that:
- the number of annual publications on acupuncture for chronic pain has increased over time;
- the main types of literature are original articles (1091 articles, 67.5 %) and review articles (351 articles, 21.7 %);
- China had the most publications (598 articles, 37 %), with Beijing University of Traditional Chinese Medicine (93 articles, 5.8 %);
- Evidence-based Complementary and Alternative Medicine ranked first (169 articles, 10.45 %) as the most prolific affiliate and journal, respectively;
- Liang FR was the most productive author (43 articles);
- the article published by Vickers Andrew J in 2012 had the highest number of citations (625 citations).
Recently, “acupuncture” and “pain” appeared most frequently. The hot topics in acupuncture for chronic pain based on keywords clustering analysis were experimental design, hot diseases, interventions, and mechanism studies. According to burst analysis, the main research frontiers were functional connectivity (FC), depression, and risk.
The authors concluded that this study provides an in-depth perspective on acupuncture for chronic pain studies, revealing pivotal points, research hotspots, and research trends. Valuable ideas are provided for future research activities.
I might disagree with the authors’ conclusion and would argue that they have demonstrated that:
- the acupuncture literature is dominated by China, which is concerning because we know that 1) these studies are of poor quality, 2) never report negative findings, and 3) are often fabricated;
- the articles tend to be published in journals that are more than a little suspect.
As we have seen recently, the reliable evidence that acupuncture remains effective is wafer-thin. Therefore, I feel that we are currently being misled by a flurry of rubbish publications that have one main aim: to distract from the fact that acupuncture might be nonsense.
Migraines are common headache disorders and risk factors for subsequent strokes. Acupuncture has been widely used in the treatment of migraines; however, few studies have examined whether its use reduces the risk of strokes in migraineurs. This study explored the long-term effects of acupuncture treatment on stroke risk in migraineurs using national real-world data.
A team of Taiwanese researchers collected new migraine patients from the Taiwan National Health Insurance Research Database (NHIRD) from 1 January 2000 to 31 December 2017. Using 1:1 propensity-score matching, they assigned patients to either an acupuncture or non-acupuncture cohort and followed up until the end of 2018. The incidence of stroke in the two cohorts was compared using the Cox proportional hazards regression analysis. Each cohort was composed of 1354 newly diagnosed migraineurs with similar baseline characteristics. Compared with the non-acupuncture cohort, the acupuncture cohort had a significantly reduced risk of stroke (adjusted hazard ratio, 0.4; 95% confidence interval, 0.35–0.46). The Kaplan–Meier model showed a significantly lower cumulative incidence of stroke in migraine patients who received acupuncture during the 19-year follow-up (log-rank test, p < 0.001).
The authors concluded that acupuncture confers protective benefits on migraineurs by reducing the risk of stroke. Our results provide new insights for clinicians and public health experts.
After merely 10 minutes of critical analysis, ‘real-world data’ turn out to be real-bias data, I am afraid.
The first question to ask is, were the groups at all comparable? The answer is, NO; the acupuncture group had
- more young individuals;
- fewer laborers;
- fewer wealthy people;
- fewer people with coronary heart disease;
- fewer individuals with chronic kidney disease;
- fewer people with mental disorders;
- more individuals taking multiple medications.
And that are just the variables that were known to the researcher! There will be dozens that are unknown but might nevertheless impact on a stroke prognosis.
But let’s not be petty and let’s forget (for a minute) about all these inequalities that render the two groups difficult to compare. The potentially more important flaw in this study lies elsewhere.
Imagine a group of people who receive some extra medical attention – such as acupuncture – over a long period of time, administered by a kind and caring therapist; imagine you were one of them. Don’t you think that it is likely that, compared to other people who do not receive this attention, you might feel encouraged to look better after your health? Consequently, you might do more exercise, eat more healthily, smoke less, etc., etc. As a result of such behavioral changes, you would be less likely to suffer a stroke, never mind the acupuncture.
SIMPLE!
I am not saying that such studies are totally useless. What often renders them worthless or even dangerous is the fact that the authors are not more self-critical and don’t draw more cautious conclusions. In the present case, already the title of the article says it all:
Acupuncture Is Effective at Reducing the Risk of Stroke in Patients with Migraines: A Real-World, Large-Scale Cohort Study with 19-Years of Follow-Up
My advice to researchers of so-called alternative medicine (SCAM) and journal editors publishing their papers is this: get your act together, learn about the pitfalls of flawed science (most of my books might assist you in this process), and stop misleading the public. Do it sooner rather than later!
In this study, the impact of a multimodal integrative oncology pre- and intraoperative intervention on pain and anxiety among patients undergoing gynecological oncology surgery was explored.
Study participants were randomized into three groups:
- Group A received preoperative touch/relaxation techniques, followed by intraoperative acupuncture, plus standard care;
- Group B received preoperative touch/relaxation only, plus standard care;
- Group C (the control group) received standard care.
Pain and anxiety were scored before and after surgery using the Measure Yourself Concerns and Wellbeing (MYCAW) and Quality of Recovery (QOR-15) questionnaires, using Part B of the QOR to assess pain, anxiety, and other quality-of-life parameters.
A total of 99 patients participated in the study: 45 in Group A, 25 in Group B, and 29 in Group C. The three groups had similar baseline demographic and surgery-related characteristics. Postoperative QOR-Part B scores were significantly higher in the treatment groups (A and B) when compared with controls (p = .005), including for severe pain (p = .011) and anxiety (p = .007). Between-group improvement for severe pain was observed in Group A compared with controls (p = .011). Within-group improvement for QOR depression subscales was observed in only the intervention groups (p <0.0001). Compared with Group B, Group A had better improvement of MYCAW-reported concerns (p = .025).
The authors concluded that a preoperative touch/relaxation intervention may significantly reduce postoperative anxiety, possibly depression, in patients undergoing gynecological oncology surgery. The addition of intraoperative acupuncture significantly reduced severe pain when compared with controls. Further research is needed to confirm these findings and better understand the impact of intraoperative acupuncture on postoperative pain.
Regular readers of my blog know only too well what I am going to say about this study.
Imagine you have a basket full of apples and your friend has the same plus a basket full of pears. Who do you think has more fruit?
Dumb question, you say?
Correct!
Just as dumb, it seems, as this study: therapy A and therapy B will always generate better outcomes than therapy B alone. But that does not mean that therapy A per se is effective. Because therapy A generates a placebo effect, it might just be that it has no effect beyond placebo. And that acupuncture can generate placebo effects has been known for a very long time; to verify this we need no RCT.
As I have so often pointed out, the A+B versus B study design never generates a negative finding.
This is, I fear, precisely the reason why this design is so popular in so-called alternative medicine (SCAM)! It enables promoters of SCAM (who are not as dumb as the studies they conduct) to pretend they are scientists testing their therapies in rigorous RCTs.
The most disappointing thing about all this is perhaps that more and more top journals play along with this scheme to mislead the public!
This pilot study tested the feasibility of using US Food and Drug Administration (FDA)–recommended endpoints to evaluate the efficacy of acupuncture in the treatment of IBS. It was designed as a multicenter randomized clinical trial, conducted in 4 tertiary hospitals in China from July 1, 2020, to March 31, 2021, and 14-week data collection was completed in March 2021. Individuals with a diagnosis of IBS with diarrhea (IBS-D) were randomized to 1 of 3 groups:
- acupuncture groups 1 (using specific acupoints [SA])
- acupuncture group 2 (using nonspecific acupoints [NSA])
- sham acupuncture group (non-acupoints [NA])
Patients in all groups received twelve 30-minute sessions over 4 consecutive weeks at 3 sessions per week, ideally every other day.
The primary outcome was the response rate at week 4, which was defined as the proportion of patients whose worst abdominal pain score (score range, 0-10, with 0 indicating no pain and 10 indicating unbearable severe pain) decreased by at least 30% and the number of type 6 or 7 stool days decreased by 50% or greater.
Ninety patients (54 male [60.0%]; mean [SD] age, 34.5 [11.3] years) were enrolled, with 30 patients in each group. There were substantial improvements in the primary outcomes for all groups
- response rates in the SA group = 46.7% [95% CI, 28.8%-65.4%]
- response rate in the NSA group = 46.7% [95% CI, 28.8%-65.4%]
- response rate in the NA group = 26.7% [95% CI, 13.0%-46.2%]
The difference between the groups was not statistically significant (P = .18). The response rates of adequate relief at week 4 were 64.3% (95% CI, 44.1%-80.7%) in the SA group, 62.1% (95% CI, 42.4%-78.7%) in the NSA group, and 55.2% (95% CI, 36.0%-73.0%) in the NA group (P = .76). Adverse events were reported in 2 patients (6.7%) in the SA group and 3 patients (10%) in NSA or NA group.
The authors concluded that acupuncture in both the SA and NSA groups showed clinically meaningful improvement in IBS-D symptoms, although there were no significant differences among the 3 groups. These findings suggest that acupuncture is feasible and safe; a larger, sufficiently powered trial is needed to accurately assess efficacy.
WHAT A LOAD OF TOSH!
Here are some of the most obvious issues I have with this new study:
- A pilot study is not about reporting effectiveness/efficacy but about testing the feasibility of a study.
- That acupuncture is feasible has been known for ~2000 years.
- The conclusion that acupuncture is safe is not warranted on the basis of the data; for that we would need a much larger investigation.
- The authors seem to have used our sham needle without acknowledging it.
- The authors are affiliated with the International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, yet they state that they have no conflicts of interest.
- The results are clearly negative, yet the authors seem to attempt to draw a positive conclusion.
The main question that occurs to me is this: how low has the JAMA sunk to publish such junk?
Like traditional acupuncture, “cosmetic acupuncture” involves the insertion of needles into the skin. Also called facial rejuvenation acupuncture, cosmetic acupuncture is believed to stimulate collagen and therefore reduce the look of wrinkles. They also claim that cosmetic acupuncture rejuvenates your skin by improving your overall energy and is a great addition to your overall wellness routine – at least, this is what enthusiasts want us to believe. 
No surprise then that many consumers give cosmetic acupuncture a try. But what, if after paying for a session, you don’t notice any difference? What, if you even look worse than before?
Impossible?
Not at all! One of the few studies on the subject showed that about half of the clients complained of blotchiness and hyperpigmented spots.
Cosmetic acupuncturists are well prepared for this argument and claim that the treatment will take longer to show any results: “Most cosmetic acupuncture treatments are meant to be taken in a series, generally in a group of 10,” says DiLibero. “The effects of acupuncture are cumulative, so follow-up appointments are recommended.”
And what does the evidence tell us about the effectiveness of cosmetic acupuncture?
One study showed “promising results as a therapy for facial elasticity”. Another one “showed clinical potential for facial wrinkles and laxity.”
That’s great!
No, it isn’t; the studies were published in 3rd class journals and did not even have control groups. Sorry, but I don’t call this evidence. In fact, the type of study that merits the term has not emerged. In other words, cosmetic acupuncture is a swindle!
But at least cosmetic acupuncture is not harmful.
Wrong!
- It will cost you a lot of money because the therapist will persuade you that you need 10 treatment sessions or more.
- It can cause blotchiness and hyperpigmented spots, as mentioned above.
- It has been reported to cause extensive facial sclerosing lipogranulomatosis.
So, you want to improve your looks?
I am not sure what therapies work for this purpose. But I do know that cosmetic acupuncture isn’t one of them.
Is acupuncture more than a theatrical placebo? Acupuncture fans are convinced that the answer to this question is YES. Perhaps this paper will make them think again.
A new analysis mapped the systematic reviews, conclusions, and certainty or quality of evidence for outcomes of acupuncture as a treatment for adult health conditions. Computerized search of PubMed and 4 other databases from 2013 to 2021. Systematic reviews of acupuncture (whole body, auricular, or electroacupuncture) for adult health conditions that formally rated the certainty, quality, or strength of evidence for conclusions. Studies of acupressure, fire acupuncture, laser acupuncture, or traditional Chinese medicine without mention of acupuncture were excluded. Health condition, number of included studies, type of acupuncture, type of comparison group, conclusions, and certainty or quality of evidence. Reviews with at least 1 conclusion rated as high-certainty evidence, reviews with at least 1 conclusion rated as moderate-certainty evidence and reviews with all conclusions rated as low- or very low-certainty evidence; full list of all conclusions and certainty of evidence.
A total of 434 systematic reviews of acupuncture for adult health conditions were found; of these, 127 reviews used a formal method to rate the certainty or quality of evidence of their conclusions, and 82 reviews were mapped, covering 56 health conditions. Across these, there were 4 conclusions that were rated as high-certainty evidence and 31 conclusions that were rated as moderate-certainty evidence. All remaining conclusions (>60) were rated as low- or very low-certainty evidence. Approximately 10% of conclusions rated as high or moderate-certainty were that acupuncture was no better than the comparator treatment, and approximately 75% of high- or moderate-certainty evidence conclusions were about acupuncture compared with a sham or no treatment.
Three evidence maps (pain, mental conditions, and other conditions) are shown below
The authors concluded that despite a vast number of randomized trials, systematic reviews of acupuncture for adult health conditions have rated only a minority of conclusions as high- or moderate-certainty evidence, and most of these were about comparisons with sham treatment or had conclusions of no benefit of acupuncture. Conclusions with moderate or high-certainty evidence that acupuncture is superior to other active therapies were rare.
These findings are sobering for those who had hoped that acupuncture might be effective for a range of conditions. Despite the fact that, during recent years, there have been numerous systematic reviews, the evidence remains negative or flimsy. As 34 reviews originate from China, and as we know about the notorious unreliability of Chinese acupuncture research, this overall result is probably even more negative than the authors make it out to be.
Considering such findings, some people (including the authors of this analysis) feel that we now need more and better acupuncture trials. Yet I wonder whether this is the right approach. Would it not be better to call it a day, concede that acupuncture generates no or only relatively minor effects, and focus our efforts on more promising subjects?
An international team of researchers described retracted papers originating from paper mills, including their characteristics, visibility, and impact over time, and the journals in which they were published. The term paper mill refers to for-profit organizations that engage in the large-scale production and sale of papers to researchers, academics, and students who wish to, or have to, publish in peer-reviewed journals. Many paper mill papers included fabricated data.
All paper mill papers retracted from 1 January 2004 to 26 June 2022 were included in the study. Papers bearing an expression of concern were excluded. Descriptive statistics were used to characterize the sample and analyze the trend of retracted paper mill papers over time, and to analyze their impact and visibility by reference to the number of citations received.
In total, 1182 retracted paper mill papers were identified. The publication of the first paper mill paper was in 2004 and the first retraction was in 2016; by 2021, paper mill retractions accounted for 772 (21.8%) of the 3544 total retractions. Overall, retracted paper mill papers were mostly published in journals of the second highest Journal Citation Reports quartile for impact factor (n=529 (44.8%)) and listed four to six authors (n=602 (50.9%)). Of the 1182 papers, almost all listed authors of 1143 (96.8%) paper mill retractions came from Chinese institutions, and 909 (76.9%) listed a hospital as a primary affiliation. 15 journals accounted for 812 (68.7%) of 1182 paper mill retractions, with one journal accounting for 166 (14.0%). Nearly all (n=1083, 93.8%) paper mill retractions had received at least one citation since publication, with a median of 11 (interquartile range 5-22) citations received.
The authors concluded that papers retracted originating from paper mills are increasing in frequency, posing a problem for the research community. Retracted paper mill papers most commonly originated from China and were published in a small number of journals. Nevertheless, detected paper mill papers might be substantially different from those that are not detected. New mechanisms are needed to identify and avoid this relatively new type of misconduct.
China encourages its researchers to publish papers in return for money and career promotions. Furthermore, medical students at Chinese universities are required to produce a scientific paper in order to graduate. Paper mills openly advertise their services on the Internet and maintain a presence on university campuses. The authors of this analysis reference another recent article (authored by two Chinese researchers) that throws more light on the problem:
This study used data from the Retraction Watch website and from published reports on retractions and paper mills to summarize key features of research misconduct in China. Compared with publicized cases of falsified or fabricated data by authors from other countries of the world, the number of Chinese academics exposed for research misconduct has increased dramatically in recent years. Chinese authors do not have to generate fake data or fake peer reviews for themselves because paper mills in China will do the work for them for a price. Major retractions of articles by authors from China were all announced by international publishers. In contrast, there are few reports of retractions announced by China’s domestic publishers. China’s publication requirements for physicians seeking promotions and its leniency toward research misconduct are two major factors promoting the boom of paper mills in China.
As the authors of the new analysis point out: “Fraudulent papers have negative consequences for the scientific community and the general public, engendering distrust in science, false claims of drug or device efficacy, and unjustified academic promotion, among other problems.” On this blog, I have often warned of research originating from China (some might even think that this is becoming an obsession of mine but I do truly think that this is very important). While such fraudulent papers may have a relatively small impact in many areas of healthcare, their influence in the realm of TCM (where the majority of research comes from China) is considerable. In other words, TCM research is infested by fraud to a degree that prevents drawing meaningful conclusions about the value of TCM treatments.
I feel strongly that it is high time for us to do something about this precarious situation. Otherwise, I fear that in the near future no respectable scientist will take TCM seriously.
