Chinese studies
Postherpetic neuralgia (PHN) is a refractory neuropathic pain condition with limited therapeutic options. Although electroacupuncture has demonstrated potential analgesic effects, high-quality evidence from rigorous randomized clinical trials remains limited.
This multicenter, randomized, sham-controlled clinical trial determined whether electroacupuncture reduces pain severity compared with sham electroacupuncture and evaluated its safety in patients with PHN. It took place at 7 tertiary hospitals in China and enrolled participants from October 2020 to July 2022, with the last follow-up in September 2022. Data analyses were performed from August to December 2025. Participants with PHN aged 45 to 75 years and moderate to severe pain (11-point Numeric Rating Scale [NRS-11] score ≥4) were recruited. Of 1072 patients screened, 624 were excluded. The remaining 448 participants were randomized to electroacupuncture (n = 225) or sham electroacupuncture (n = 223); 383 participants (85.49%) completed the trial. Patients received 20 sessions of electroacupuncture or sham electroacupuncture over 4 weeks, followed by a 4-week posttreatment follow-up. The primary outcome was the change in the NRS-11 scores from baseline to week 4, with responders defined as participants achieving a 30% or more reduction in NRS-11 scores.
Of 448 participants, the mean (SD) age was 63.19 (9.26) years, 233 (52.01%) were male, and 215 were female (47.99%). At week 4, the electroacupuncture group had a greater decrease in the NRS-11 scores (−1.52) than the sham electroacupuncture group (−0.99) with an adjusted mean difference of −0.53 (95% CI, −0.61 to −0.43; P < .001), and the responder rate was significantly higher in the electroacupuncture group (46.68%) than in the sham electroacupuncture group (24.28%) (adjusted risk difference, 22.40%; 95% CI, 13.02%-31.79%; P < .001). These treatment benefits persisted through a 1-month follow-up; no clinically significant adverse events were observed.
The authors concluded that, among patients with PHN in this study, electroacupuncture provided a statistically significant reduction in pain severity, increased responder rates, and improved pain-related functional outcomes. These benefits suggest that electroacupuncture may be a useful nonpharmacological option for integrated management of PHN.
Here are a few points of concern and criticism:
- The authors state that the study was funded by the Evidence-Based Capacity Building Project for Traditional Chinese Medicine from National Administration of Traditional Chinese Medicine, the National Natural Science Foundation of China, the Natural Science Foundation of Jiangsu Province, Young Elite Scientists Sponsorship Program by China Association of Chinese Medicine, Youth Talent Project of Jiangsu Province Administration of Traditional Chinese Medicine, and Nanjing University of Chinese Medicine Double-Hundred Talent Program. Yet, they insist they had no conflict of interest.
- Acupuncture studies from China are as good as never negative. As frequently noted on this blog, the vast majority of Chinese studies seem to rely on falsified data.
- The authors imply that their study was patient-blind; yet there is no way that this is true: 1) The verum was administered to elicit ‘de-qi’, while the sham was not. 2) The electrical current in the verum group induced mild muscle twitching, while the sham group had no such experience. This means the verum patients knew the were receiving verum and thus were expecting an effective therapy. By contrast, the control group would have comprehended that they were given a placebo and were disappointed. These effects inevitably contribute to the outcome. In fact, I would agruge that they suffice in bringing them about without any contribution of a specific acupuncture effect. At the very minimum, the authors should have discussed these issues fully and critically.
- The acupuncturists of this study were also not blind. It is possible – I would argue, even likely – that they influenced patients to report or experience more positive results. Again, I would suggest that such effects suffice to generate a false-positive outcome.
- Even if there was a true effect of the verum beyond placebo, the question is, was it caused by acupuncture or the electrical current? There is a sizable body of evidence suggestion that electrotherapy might be effective for PHN!
In conclusion, the assertion that “electroacupuncture provided a statistically significant reduction in pain severity, increased responder rates, and improved pain-related functional outcomes” is uncritical, promotional and unjustified. I am once again dismayed that a reputable journal publishes such overt rubbish.
When a top journal like PNAS (Procedings of the Nationsl Academy of Science) publishes an article entitled “What’s the science behind acupuncture?“, I must take notice. Here is my take on the (sadly disappointing) effort:
My very short summary of the paper (I do encourange my readers to read it in full)
The article starts from the premise that acupuncture is proven to work, an assumption that – as we will see in a minute – is not based on sound evidence. It describes the evolution of acupuncture from a traditional practice rooted in ancient concepts like “qi” and “meridians” to a modern medical treatment increasingly validated by science. It argues that practitioners like Min Chen are today able to provide evidence-based explanations for their work. While early clinical trials were plagued by the “sham” acupuncture paradox, the text argues that more recent, rigorous studies and technological projects are bridging the gap between Eastern philosophy and evidence-based medicine, suggesting that acupuncture’s effects are physiological realities rather than mere placebo.
My concerns of the paper
The article attempts to bridge the gap between Traditional Chinese Medicine (TCM) and conventional medicine suggesting that several anatomical discoveries “correspond” to ancient meridians. This, however, is a post hoc ergo propter hoc fallacy. Finding a morphological structure (e.g. fascia) and claiming it represents the meridian system ignores that meridians were conceptualized as functional energetic conduits, not anatomical vessels. Citing an 80% overlap between acupoints and connective tissue planes lacks specificity. Given the ubiquity of connective tissue in the human frame, any randomized point on the body would likely “overlap” with a tissue plane, rendering the “meridian” map a possible exercise in pattern-seeking rather than anatomical discovery.
The paper acknowledges the “most puzzling” finding that sham acupuncture often produces results comparable to “true” acupuncture. This, it would seem to me, invalidates the foundational TCM theory of specific “acupoints” and “meridians” is invalidated. Yet, the article suggests that sham acupuncture is “not a true placebo” because it also triggers biological pathways. If needling anywhere produces an effect, acupuncture is merely a generalized, non-specific neuro-modulatory stimulus.
The article quotes Chen on “harmonizing organ functions” and “regulating qi” as well as researchers referring to “fibroblast activation” and “vagus nerve stimulation”. The author seems to consider both to be true; yet they seem mutually exclusive. Translating metaphysical concepts into physical phenomena does not “validate” the original theory but merely replaces it.
The article employs the opioid crisis to justify the rise of acupuncture. Yes, the need for non-pharmacological pain management is urgent, but clinical necessity does not equate to scientific validity. The text quotes the “lasting benefits” observed in some meta-analyses without discussing the often fatal flaws in these papers. Furthermore, it fails to cite the substantial body of evidence suggesting that acupuncture is not effective. Moreover, it hardly mentions the small effect sizes and hence limited clinical usefulness found in the positive studies.
The final section of the paper essentially rebrands acupuncture as “bioelectronic medicine”. If its mechanism of action is purely the electrical stimulation of the vagus nerve or the release of endogenous opioids, then the TCM concepts are all but superfluous. If a cheap and wearable TENS unit is more or less equivalent, the “meridian” and “qi” myths are obsolete.
In summary, the paper reads, I fear, only marginally better than a Chinese government promotional text – most disappointing for an article published in a journal of high standing. It attempts to preserve the cultural prestige of TCM while stripping it of its internal logic in order to make it compatible with science. For acupuncture to gain a true “scientific footing”, research must, in my view, move beyond finding “tantalizing” correlations. It should address fundamental problems, e.g.:
- As long as we have no convincing proof that acupuncture works beyond placebo, discussions about its mechanisms are futile.
- If qi, acupoints and meridians are illusions and irrelevant for the clinical outcome, then the science is not validating acupuncture but merely re-discovering a well-known non-specific form of peripheral nerve stimulation.
Sufficient evidence concerning the impact of traditional Chinese medicine (TCM) on clinical outcomes for breast cancer patients in Taiwan is not available. This study sought to examine the association between TCM integration and post-operative outcomes among women undergoing mastectomies.
Utilizing a large insurance database, the Taiwanese researchers identified a cohort of adult women who underwent breast cancer surgery during the 2010–2019 period. They compared sociodemographic profiles and comorbidities between TCM users and non-users. Multiple logistic regression models were employed to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for both mortality and postoperative complications.
Among 91,298 eligible patients, the one-year pre-operative prevalence of TCM utilization was 40%. Compared to the control group, TCM users demonstrated:
- a significantly lower likelihood of postoperative stroke (OR 0.76, 95% CI 0.62–0.93),
- and a reduced requirement for intensive care (OR 0.74, 95% CI 0.59–0.91).
Moreover, the cumulative exposure of more than 4 TCM consultations within the year preceding surgery was linked to a decreased risk of stroke (OR 0.76, 95% CI 0.61–0.95).
The authors concluded that “our findings indicate that integrating TCM during the year preceding breast cancer surgery is correlated with lower risks of postoperative stroke and a reduced requirement for intensive care. Nevertheless, these observed benefits warrant further verification through prospective and large-scale clinical investigations. Based on these results, we suggest that both Western medical practitioners and public health administrators should be mindful of TCM’s role in the comprehensive care of patients with breast cancer.”
In the paper itelf, the authors “hypothesize that pre-operative TCM integration contributes to the observed reduction in stroke risk and intensive care requirements following mastectomy. These prior insights provide a plausible biological foundation for the favorable outcomes observed in our study”. In other words, they believe that the associations is causal.
I beg to differ!
Much research has demonstrated that people who use so-called alternative medicine (SCAM) in addition to conventional therapies differ from those who don’t. In general, they tend to be more health concious – if not, they would not go to the trouble of using and paying for SCAM. This difference alone suffices to bring about the observed outcomes – even if TCM has no or perhaps a slightly negative overall health effect.
But let’s be generous!
Let’s assume the authors are correct in assuming that the association is causal and that TCM brought about the observed outcomes.
What does that actually mean?
TCM consists of many different modalities. If we just focus on oral medications and assume that there are 1000 different ones [in fact, the number is about 6 times higher], which one do we take to experience the observed outcome? Perhaps all of them?
What I am trying to point out that such research is meaningless; it has zero practical consequences, even if its results were real – which they probably are not.
In the end, it boils down to one main thing: the promotion of unproven (and occasionally dangerous) TCM.
Psoriasis is an immune-mediated inflammatory skin disease. By more than a decade of clinical validation, Jueyin granules (JYG) have demonstrated multi-target synergistic immunomodulatory and anti-inflammatory effects, offering a characteristic Traditional Chinese Medicine (TCM) therapeutic approach for psoriasis.
Aim of this study was to assess the efficacy and safety of oral JYG in treating psoriasis with blood-heat syndrome. Participants with body surface area (BSA) score less than 10 were allocated to receive JYG or placebo treatment in a 1:1 ratio through central area division and block randomization. The primary outcome is reduction of the psoriasis area severity index (PASI) score and proportion of participants achieving a greater than 50 % reduction in PASI scores (PASI50) at week 8.
Between November 2019 and April 2022, 195 participants were randomly assigned to receive JYG (n = 99) or a placebo (n = 96) at five centers. The JYG group demonstrated significantly greater reductions in PASI and BSA scores than the placebo group at week 8 (both P < 0.001) and maintained these improvements at week 16 (P < 0.001 and P = 0.005, respectively). By week 8, 51.09 % of participants in the JYG group achieved PASI50, compared to 20.65 % in the placebo group (P < 0.001). However, there were no statistical differences in dermatology life quality index (DLQI), visual analog scale (VAS) scores, or relapse rate.
The authors concluded that this study provides conclusive evidence that JYG is a safe and effective treatment for patients with mild-to-moderate psoriasis. The current findings support its use as a complementary and alternative therapy for psoriasis.
I think this paper needs a few explanations:
- What are Jueyin granules? This is a formula consisting of eight Chinese herbs (Haliotis diversicolor, Flos Lonicerae Japonicae, Radix Rehmanniae exsiccate, cortex moutan, Herba Hedyotisdiffusae, Folium isatidis, Smilax china L. and Radix Curcumae)
- What is the history? The formula was developed in the 1950s by Han Xia, a Chinese surgeon, and have been used to treat psoriasis for over 50 years by Yueyang Hospital of Integrated Traditional Chinese and Western Medicine.
- How did he develop it? We don’t know.
- Is the formula available outside China? No, not to the best of my knowledge.
- How reliable is this new trial? As we have discussed repeatedly on this blog, there are good reasons to mistrust Chinese studies.
- If we accept the findings nonetheless, are the conclusions valid? No! Firstly, this study cannot establish the safety of the formula. Secondly, a single trial cannot ‘conclusively’ establish the effectiveness of a therapy.
- Why does a respected journal publish such a dubious study? SERACH ME!
This study aimed to evaluate the comparative effectiveness of “fire cupping therapy” (FC) versus electroacupuncture for reducing pain and improving cervical spine range of motion in patients with neck pain due to cervical spondylosis. FC is essentially nothing else than the TCM version of cupping.
Eighty-two participants with neck pain caused by cervical spondylosis were randomly allocated in 1:1 ratio to either the fire cupping (FC) or the electroacupuncture (EA) group. Both groups received treatment at the EX-B2, A-shi, and GB21 acupuncture points. The two-week study assessed pain levels using the Visual Analog Scale (VAS) at 2 points in time post-intervention and evaluated adverse effects weekly.
After 2 weeks of intervention, VAS scores significantly decreased in both the FC group (from 6 (6–7) to 3 (2–3)) and the EA group (from 6 (6–7) to 2 (1–3)) (p<0.001). However, inter-group pain relief was not statistically significant (p = 0.5794, Cohen’s d = 21 0.12; 95% CI [-0.31–0.6]). Both groups showed statistically significant ROM improvement (p<0.001), though the EA group demonstrated better improvement in flexion, extension, and left/right lateral flexion (p<0.05). No adverse effects of FC were reported.
The authors concluded that FC appears to be an effective and safe therapy for neck pain due to cervical spondylosis, showing similar pain relief efficacy with no statistically significant difference compared to electroacupuncture despite a lower treatment dosage. However, due to methodological limitations, these findings should be interpreted with caution and warrant further validation in rigorously designed studies.
I do agree with the authors’ call for caution – but with little else of what they state. Here are some of my concerns:
- A trial comparing two supposedly active treatments is an ‘equivalence study’; and such investigations require much larger sample sizes that 80.
- Equivalence studies only make sense, if one of the two treatments has been shown beyond doubt to be effective; this is not the case for electroacupuncture nor for FC.
- As it stands, the study does not control for placebo effects; thus the findings are in accordance with both treatments being pure placebos.
- A study with 80 patients tells us as good as nothing about the safety of the iterventions; to draw conclusions about safety is thus unwarranted
My conclusion (yet again) is this:
If you design a nonsense study, you are asking for a nonsense result.
Acupuncture is considered an effective complementary therapy for major depressive disorder (MDD), yet current findings remain inconsistent, and its overall quality is uncertain. Therefore, this systematic review summarizes the existing evidence on acupuncture for MDD, providing an overview of the current research, identifying gaps and limitations in the literature, and offering guidance for future research.
A Chinese team of researchers systematically searched eight electronic databases (PubMed, EMBASE, CDSR, CENTRAL, CNKI, Wanfang, VIP, and SinoMed) and seven guideline repositories (Trip, AHRQ, NICE, NZGG, GIN, CMACPG, and NHMRC) from inception to November 15, 2024, for RCTs, systematic reviews, and clinical practice guidelines on acupuncture for major depressive disorder. Eligibility criteria were defined according to the PICOS framework. Two reviewers independently screened studies, extracted data, and assessed quality using the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and AMSTAR-2 for systematic reviews (SRs). Key evidence and recommendations were synthesized and presented in tables and figures.
A total of 374 studies were identified, including 330 RCTs, 35 SRs, and 9 clinical guidelines. Among these studies, 307 (93.03%) were published in Chinese and 23 (6.97%) in English. The RCTs generally involved small sample sizes (50 to 100 participants). The primary intervention was acupuncture combined with antidepressant medication (50%), while 79.39% of studies used antidepressants as the main control. Nearly all studies (97.88%) used changes in depression severity as the primary outcome, although the risk of bias was unclear in 80.3% of cases.
Of the SRs, 97.14% reported positive findings favoring acupuncture’s potential benefits, but 74.29% were rated as very low in methodological quality, lacking thorough bias assessments. Among the two acupuncture-specific guidelines and seven broader guidelines, recommendations for acupuncture in managing MDD varied considerably.
The authors concluded that the evidence from RCTs, SRs, and clinical guidelines suggests that acupuncture may reduce depressive symptom severity and provide additional benefits for patients with comorbid anxiety, sleep disturbances, or somatic symptoms, particularly when used as an adjunctive therapy. However, these findings are mainly based on small-scale trials with methodological limitations, and most guidelines recommend acupuncture only as a third-line complementary option. Further large, high-quality RCTs are needed to strengthen the evidence base and inform future guideline development.
For the following reasons, the conclusions are, in my opinion, wrong:
- Almost all RCTs came from China (we have discussed the untrustworthiness of these trials many times previously, e.g. here or here).
- Almost all studies were methodologically flawed.
Therefore, I suggest a more accurate conclusion based on the available data:
The evidence from RCTs, SRs, and clinical guidelines is unreliable due to the poor quality of the available data. Until reliable evidence is available, acupuncture is not a recommendable therapy for MDD, a life-threatening condition.
Much of my blog is dedicated to poor research of so-called alternative medicine (SCAM) conducted by biased researchers, published in lousy journals, edited by careless editors and reviewed by irresponsible reviewers. I have warned many times that this practice is polluting the medical literature with devastating consequences.
Over the years, this problem has sharply increased due to ‘paper mills’, AI and other issues. Eventually, I got the impression that hardly anyone cares about this rapid decline.
This article shows that I WAS WRONG! Here is its abstract but I urge everyone to study the pull paper:
Science relies on integrity and trustworthiness. But scientists under career pressure are lured to purchase fake publications from ‘paper mills’ that use AI-generated data, text and image fabrication. The number of low-quality or fraudulent publications is rising to hundreds of thousands per year, which—if unchecked—will damage the scientific and economic progress of our societies. The result is editor and reviewer fatigue, irreproducible experiments, misguided experiments, disinformation and escalating costs that devour funding from taxpayers intended for research. It is high time to reevaluate current publishing models and outline a global plan to stop this unhealthy development. A conference was therefore organized by the Royal Swedish Academy of Sciences to draft an action plan with specific recommendations, as follows. (i) Academia should resume control of publishing using non-profit publishing models (e.g. diamond open-access). (ii) Adjust incentive systems to merit quality, not quantity, in a reputation economy where the gaming of publication numbers and citation metrics distorts the perception of academic excellence. (iii) Implement mechanisms to prevent and detect fake publications and fraud which are independent of publishers. (iv) Draft and implement legislations, regulations and policies to increase publishing quality and integrity. This is a call to action for universities, academies, science organizations and funders to unite and join this effort.
Of course, the paper was not written with SCAM in mind. The problem exists in all science. Yet I am convinced that in the realm of SCAM it is particularly acute. The actions proposed in the paper for improving the present situation are all very reasonable (but nobody should fool themselves by thinking that they are easy to implement!). Let’s hope that everyone concerned takes careful note and do what they can to avert an otherwise inevitable calamity.
This study summarizes and discusses the characteristics and essence of meridians and acupoints from the perspectives of physics, chemistry and biology. An extensive body of literature from PubMed and the China National Knowledge Infrastructure was reviewed and categorized into three distinct groups: physical characteristics-related research (75 articles), which examined electrical, thermal, optical, acoustic and magnetic properties, and isotope migration; chemical characteristics-related literature (44 articles), focusing on chemical ions, oxygen partial pressure, nitric oxide and substance P; and biological essence-related research (52 articles), which primarily explored microcirculation, extracellular fluid channels, mast cells, telocytes, connexins, hilum of muscle and bone, and sensory nerve fibers. Current research emphasizes the electrical and thermal properties of the meridians and acupoints, whereas investigations into the essence of meridians are increasingly shifting from macroscopic to microscopic structures.
The authors concluded that it is essential to fully harness the advantages of interdisciplinary integration, which could significantly advance our understanding and applications in the realm of acupuncture and traditional medicine.
Why?
Why should it be “essential” to do that?
I would have thought it might be important [not essential] to review this subject as one reviews any subject in science. This would mean that one needs to discuss critically the evidence and plausibility of the concepts.
Sadly, the authors of this paper did the exact opposite. They cherry-picked the fairly extensive literature that aims to prove the existance of TCM assumptions like acupoints, meridians, etc. , while the less extensive literature that questions these assumptions is swept under the carpet.
And why do they do that?
Here is a hint:
- In SCAM, non-financial conflicts of interest are MUCH more poweful that financial ones.
- If we allow biased researchers to select the evidence they like, the ‘Flat Earth Society’ can easily demonstrate that our planet has the shape of a disc.
Regular readers of this blog will know of my long-standing concerns regarding the trustworthiness of research, particularly when it originates from China. I have addressed these issues many times, e.g.:
- Research misconduct in China: an ever increasing worry
- Increasing concerns about SCAM research originating from China
- Concerning developments in acupuncture research: is there something rotten in the state of China?
- If you cannot argue against your critic, have him jailed (a chilling story from China)
- Data fabrication in China is an ‘open secret’
- Acupuncture versus Sham Acupuncture for Chronic Sciatica – another finding that is too good to be true?
- A TCM mixture improves the prognosis of heart attacks? If it sounds too good to be true, it probably is!
- Beware of Chinese acupuncture trials!
- Acupuncture for pain: plenty of useless papers and very little reliable evidence
- A meta-analysis of Chinese herbal medicine for lowering blood pressure
- JAMA just published another truly awful acupuncture study
- More compelling reasons for distrusting Chinese research papers
- A new acupuncture trial with a positive result – alas, it seems too good to be true
- Acupuncture for the prevention of headache? How to fool (almost) everyone with an RCT
- Acupuncture for male infertility (MI): a story of sloppy research endangering public health
- Reviews of Chinese Herbal Medicine: It’s a process akin to money laundering
- Disgracefully low methodological quality of systematic reviews on acupuncture
Now, some further relevant insights into these issues have emerged. A survey was conducted through a collaboration between international publisher Taylor & Francis and the National Science Library at the Chinese Academy of Sciences (CAS). It involved 1,777 students, researchers, and librarians from China, and revealed significant uncertainty about research and publishing ethics:
- 35.9% of respondents were unsure about the responsibilities involved in article authorship, with master students showing the highest levels of confusion.
- A considerable number of respondents reported engaging in ‘gift authorship’ – either adding an author to a paper or agreeing to be named as an author without meeting proper authorship criteria.
- 31% of respondents reported using services offered by third parties to help with publishing in international journals. A concerning number considered activities typically associated with paper mills acceptable, such as writing parts of a paper or adding authors and citations chosen by the agent.
- Only 55.4% of the survey respondents stated that they had access to any training in ethics and integrity, with an even smaller proportion having formal training.
The study’s authors conclude that researchers at all levels need timely, accessible, and suitable training in research integrity and publishing ethics. This training should include undergraduates and those at institutions responsible for upholding overall integrity standards. Essential topics such as authorship responsibilities and working with ethical third-party manuscript services must be part of mandatory training.
Dr Sabina Alam, Director of Publishing Ethics & Integrity at Taylor & Francis, said: “Our survey findings highlight the urgent need for training for students and researchers at all levels in China, a need we believe is also present for many students and researchers across the world. Without this, the knowledge gaps we’ve found leave researchers susceptible to exploitation by unethical organisations, such as paper mills, and many might unknowingly engage in misconduct. It’s understandable that 80% of those who responded to our survey are concerned about the impact of research integrity issues on the trustworthiness of research publications,” Alam added. “Partnerships between publishers and research institutions will be crucial for tackling global research integrity challenges, including developing and implementing comprehensive training in research integrity and publishing ethics. A key reason for our collaboration with the National Science Library at CAS was to explore important issues, and we believe these results from our Joint Lab demonstrate the benefits of working together in this way.”
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I think I should stress that these data and remarks apply to all types of research. The situation in so-called alternative medicine (SCAM) research is clearly more severe. This, I think, is true worldwide but particularly acute for research originating from China.
This cross-sectional meta-epidemiological study investigated the reporting, data sharing and spin (using reporting strategies to emphasise the benefit of non-significant results) in randomised clinical trials (RCTs) of acupuncture.
Specifically, the researchers assessed:
- (1) the reporting of acupuncture RCTs by the Consolidated Standards for Reporting Trials (CONSORT) 2010 statement and STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) checklist;
- (2) the data sharing level by the International Committee of Medical Journal Editors (ICMJE) data sharing statement;
- (3) spin frequency and level by the prespecified spin strategies.
This study evaluated 476 eligible studies, of which 166 (34.9%) explored the specific efficacy or safety of acupuncture in the nervous system, 68 (14.3%), in the motor system and 61 (12.8%) in the digestive system. The findings show:
- 244 (57.7%) studies tested conventional acupuncture, 296 (62.2%) used multicentre study design, and 369 (77.5%) were supported by institutional funding.
- 312 (65.5%) eligible studies were poorly reported. The sufficiently reporting scores of the CONSORT 2010 statement and the STRICTA checklist differed from 0.63% to 97.5%, and 32 (59.3%) items were less than 50%.
- For the data sharing level of acupuncture RCTs, only 66 (17.2%) studies followed the ICMJE data sharing statement, but 49 (14.5%) need to require authors to obtain data, and only 5 (1.5%) provided data by open access.
- Spins were identified in 408 (85.7%) studies (average spin frequencies: 2.94). 59 (37.2%) studies with non-significant primary outcomes had spin levels.
The authors concluded that the reporting of acupuncture RCTs was low compliance with the CONSORT 2010 statement, the STRICTA checklist and the ICMJE data sharing statement, and spin appeared frequently. Journal policies on using reporting guidelines, data sharing and equitable consideration of non-significant results might enhance the reporting of acupuncture RCTs.
This cannot surprise anyone who has followed my blog where we have repeatedly discussed the lamentable quality of acupuncture trials, e.g.:
- Insufficient reporting of adverse effects in acupuncture trials
- Acupuncture research at its worst
- A new trial concludes that “acupuncture can be used as an optional preventive therapy for chronic migraine” – but I beg to differ.
- Acupuncture for smoking cessation? I don’t think so!
- If you design a clinical trial badly, you might get an invalid result: Laser- vs electro-acupuncture
- Beware of Chinese acupuncture trials!
- Possibly the worst acupuncture study of the year so far
- Acupuncture reduces the risk of dementia – oh, really?
- Acupuncture for pain: plenty of useless papers and very little reliable evidence
- More acupuncture promotion (sponsored by a top journal) masquerading as research
- JAMA just published another truly awful acupuncture study
- Acupuncture improves the cognitive performance of college students … Oh, really?
- Acupuncture for the prevention of headache? How to fool (almost) everyone with an RCT
- The ‘WORST PAPER OF 2022 COMPETITION’ entry No 8: Acupuncture for the Treatment of Female Sexual Dysfunction
- Poor research endangers public health! Yet another example from the realm of acupuncture
- Acupuncture for male infertility (MI): a story of sloppy research endangering public health
- Acupuncture against obesity? No, I don’t think so!
- Efficacy of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome? Another dubious study in a top journal
As I have pointed out ad nauseam, the problem stems from acupuncture enthusiasts abusing science not for testing acupuncture but for confirming their quai-religious belief that acupuncture is effective. This could be amusing to watch, but it has one important drawback: it misleads consumers and often endangers their health.
The question is: WHAT CAN BE DONE ABOUT IT?
I think consumers, decision makers, physicians, editors, etc. should become much more critical about the utter nonsense that is being published in this area. I know this is not a practical recommendation, but unfortunately I do not have a better one.
