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trogdor
Skeptic Friend
198 Posts |
 Posted - 01/23/2006 : 21:14:47
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Some time ago I got into a discussion with a number of people about acupuncture. One of the other skeptics in the debate had arthritis and others were trying to convince him to try acupuncture. At this point I referenced a article I had read in Michael Shermer's skeptic page in Scientific American.
quote:
from Sci Am
Traditional Chinese medicine holds that a life energy called Qi ("chee") flows through meridians in the body; each of the 12 main meridians represents a major organ system. On these 12 meridians are 365 acupuncture points, one for each day of the year. When yin and yang are out of balance, Qi can become blocked, leading to illness. Inserting needles at blocked points--now believed to number about 2,000--supposedly stimulates healing and health. This theory lacks any basis in biological reality, because nothing like Qi has ever been found by science. Nevertheless, a medicinal procedure like acupuncture may work for some other reason not related to the original, erroneous theory…[this] might help explain the results of a study published in the May 4, 2005, issue of the Journal of the American Medical Association, in which Klaus Linde and his colleagues at the University of Technology in Munich compared the experiences of 302 people suffering from migraines who received either acupuncture, sham acupuncture (needles inserted at nonacupuncture points) or no acupuncture. During the study, the patients kept headache diaries. Subjects were "blind" to which experimental group they were in; the evaluators also did not know whose diary they were reading. Professional acupuncturists administered the treatments. The results were dramatic: "The proportion of responders (reduction in headache days by at least 50%) was 51% in the acupuncture group, 53% in the sham acupuncture group, and 15% in the waiting list group." The authors concluded that this effect "may be due to nonspecific physiological effects of needling, to a powerful placebo effect, or to a combination of both."
In my experience, "needling" (where the acupuncturist taps and twists the flesh-embedded needle) isn't painful, but it is most definitely noticeable. If acupuncture has effects beyond placebo, it is through the physical stimulation and release of the body's natural painkillers. Finding that sham acupuncture is as effective as "real" acupuncture demonstrates that the Qi theory is full of holes.
There were two responses to this. The first was “Acupuncture has been around for thousands of years, so it must work. Would people keep using it if it was known not to work?” the second was something like this. “That was only one study. You can prove anything with one study. This means nothing” although I did not get to respond to either, the second one bothers me more. I know that repetition is important in the scientific method, but does that mean that a study that is well done is useless until it has been done again? Has anyone else encountered these sorry rebuttals?
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all eyes were on Ford Prefect. some of them were on stalks.
-Douglas Adams |
Edited by - trogdor on 01/23/2006 21:17:10
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H. Humbert
SFN Die Hard
USA
4574 Posts |
Posted - 01/23/2006 : 21:35:50 [Permalink]
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quote:
Originally posted by trogdor
The second was something like this. “That was only one study. You can prove anything with one study. This means nothing” although I did not get to respond to either, the second one bothers me more. I know that repetition is important in the scientific method, but does that mean that a study that is well done is useless until it has been done again?
Well, I wouldn't say a single study means nothing, especially if their aren't any glaring problems with the results. Obviously, however, the results of a single study can by no means be considered conclusive. Still, one study is better than no study, so it's far from useless. In my mind, it definitely shifts weight of evidence in a particular direction. More studies can either continue or reverse this trend, but the intial study is useful in setting a precedent. Any objections to the inital study must have a legitimate basis, and not simply on the fact that it is the only one of its kind.
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"A man is his own easiest dupe, for what he wishes to be true he generally believes to be true." --Demosthenes
"The first principle is that you must not fool yourself - and you are the easiest person to fool." --Richard P. Feynman
"Face facts with dignity." --found inside a fortune cookie |
| Edited by - H. Humbert on 01/23/2006 21:38:03 |
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UncleJ
New Member
41 Posts |
Posted - 01/23/2006 : 21:54:33 [Permalink]
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| I agree with H. Humbert but would also add that the study in question was published in a peer reviewed journal. To me this adds some additional weight to the validity of the study. Not only do the scientists that did the study think they did it properly but presumably the reviewers also believe the researchers did a reasonable job. |
"The Church says the Earth is flat. But I know that it is round. For I have seen the shadow on the Moon. And I have more faith in a shadow than in the Church." - F. Magellan
"I can't be a missionary! I don't even believe in Jebus!" - H. Simpson |
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Ricky
SFN Die Hard
USA
4907 Posts |
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ronnywhite
SFN Regular
501 Posts |
Posted - 01/23/2006 : 22:50:33 [Permalink]
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This is Cecil Adams ("The Straight Dope") accupuncture take as mentioned in The Skeptics Dictionary. It's funny, and it sounds pretty reasonable to me"
http://www.straightdope.com/columns/000324.html
Particularly interesting is what he notes about the Chinese accupuncture studies. |
Ron White |
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 01/25/2006 : 02:50:24 [Permalink]
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| There are some good links and other stuff on acupuncture at Quackwatch, though it looks like Dr B hasn't finished the page yet. |
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 01/25/2006 : 02:52:56 [Permalink]
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| Tell your friends bloodletting was done for centuries too. |
| Edited by - beskeptigal on 01/25/2006 02:53:52 |
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Subjectmatter
Skeptic Friend
173 Posts |
Posted - 01/25/2006 : 04:09:07 [Permalink]
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Actually, bloodletting is getting back into vogue.
Not as the universal panacea it was used as before, but for pain relief and a couple of other minor purposes... |
Sibling Atom Bomb of Couteous Debate |
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marfknox
SFN Die Hard
USA
3739 Posts |
Posted - 01/25/2006 : 05:59:08 [Permalink]
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I wonder if part of the success of acupuncture in the public eye is because it is a traditional Chinese medicine that the Chinese themselves have promoted. Asian cultures are very much into face-saving and projected an overall shining image of their own culture/nation to the rest of the world. See what happened recently with the researcher in South Korea who faked his stem cell research?
I just thought of that factor while reading this paragraph from the Cecil Adams article:
The most revealing datum was a chart showing the results of 49 trials of acupuncture in the treatment of stroke. Normally in such a chart you'd see a bell-curve distribution, with a few data points at the far ends (indicating the treatment was either extremely effective or extremely ineffective) but most in the middle. In fact the chart shows half a bell--a few trials showed acupuncture was very effective, the largest number showed it was slightly effective, and almost none showed it was ineffective. Obvious conclusion: researchers in China only publish positive results.
Plus I lived for a year in Asia and so I got first hand experience with lying to save face. I was once at dinner with my husband and Korean friend, and we got on to the topic of child abuse in America. So at one point I casually asked her "What are child abuse rates like in South Korea?" and without missing a beat she shook her head and said "We don't have that here." Yup, and did you know that kimchee cures everything from the flu to SARS? |
"Too much certainty and clarity could lead to cruel intolerance" -Karen Armstrong
Check out my art store: http://www.marfknox.etsy.com
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 01/25/2006 : 14:34:12 [Permalink]
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| Good observations Marf. I also was surprised at how much face saving got in the way of combating SARS in China. |
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Hawks
SFN Regular
Canada
1383 Posts |
Posted - 01/25/2006 : 14:43:21 [Permalink]
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quote:
Plus I lived for a year in Asia and so I got first hand experience with lying to save face. I was once at dinner with my husband and Korean friend, and we got on to the topic of child abuse in America. So at one point I casually asked her "What are child abuse rates like in South Korea?" and without missing a beat she shook her head and said "We don't have that here."
[dr. evil voice]Rrrrriiiight[/dr. evil voice]
quote:
Yup, and did you know that kimchee cures everything from the flu to SARS?
I didn't know what Kimchee was, but I can't say that it sounds very appetizing. Reminds me of the swedish "Surströmming" - fermented herrings. Even some of the die-hard fans of this stuff have to hold their noses while eating it. |
METHINKS IT IS LIKE A WEASEL
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Valiant Dancer
Forum Goalie
USA
4826 Posts |
Posted - 01/25/2006 : 15:20:55 [Permalink]
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quote:
Originally posted by beskeptigal
Tell your friends bloodletting was done for centuries too.
So were leeches, but they've made a comeback as well. (And with good science behind it, too) |
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Brother Cutlass of Reasoned Discussion |
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trogdor
Skeptic Friend
198 Posts |
Posted - 01/25/2006 : 18:56:51 [Permalink]
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quote:
Originally posted by beskeptigal
Tell your friends bloodletting was done for centuries too.
the coversation continued today and that was one of my retorts, along with powdered rino horn.
But they kept pressing with the "it's only one study" argument. I mostly agreed with H.H. anduncleJ about it being well done and peer reviewed but it would help if there was another good article published in a journal. |
all eyes were on Ford Prefect. some of them were on stalks.
-Douglas Adams |
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Dave W.
Info Junkie
USA
26022 Posts |
Posted - 01/25/2006 : 19:58:54 [Permalink]
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quote:
Originally posted by trogdor
But they kept pressing with the "it's only one study" argument. I mostly agreed with H.H. anduncleJ about it being well done and peer reviewed but it would help if there was another good article published in a journal.
Acupuncture is also supposed to be helpful for psoriasis, and so once, perhaps six years ago, I got myself into an acupuncture debate on the psoriasis Usenet group. I seem to remember quite a few studies showing sham acupuncture working just as well as real acupuncture for a large number of diseases and conditions.
A PubMed search for "acupuncture sham" results in 261 hits, although one must be careful to distinguish "traditional Chinese acupuncture" from "acupressure" (poking "acupoints" instead of needling them), "moxibustion" (acupuncture with burning herbs on the non-invasive ends of the needles), "transcutaneous electrical nerve stimulation" (aka TENS, which is low-level electrical shocks to "acupoints"), "electroacupuncture" (shocks applied to needles after insertion), "Laser acupuncture" (whatever...) and a host of other non-traditional stuff. Any attempt at proving the falsity of acupuncture by citing a study of the wrong sort of acupuncture will get ridiculed.
Here's one: "Acupuncture for subacute stroke rehabilitation: a Sham-controlled, subject- and assessor-blind, randomized trial."Acupuncture is not superior to sham treatment for recovery in activities of daily living and health-related quality of life after stroke, although there may be a limited effect on leg function in more severely affected patients. Here's another: "Acupuncture treatment in irritable bowel syndrome."Acupuncture in IBS is primarily a placebo response. Based on the small differences found between AC and SAC, a study including 566 patients would be necessary to prove efficacy of AC over SAC. The placebo response may be predicted by high coping capacity and low sleep quality in individual patients. This one, "The effectiveness of acupuncture for depression--a systematic review of randomised controlled trials," is from a journal which, by the title, one might think would be biased towards this therapy.The evidence is inconsistent on whether manual acupuncture is superior to sham, and suggests that acupuncture was not superior to waiting list. Evidence suggests that the effect of electroacupuncture may not be significantly different from antidepressant medication, weighted mean difference -0.43(95% CI -5.61 to 4.76). There is inconclusive evidence on whether acupuncture has an additive effect when given as an adjunct to antidepressant drugs. Back to the unbelievers in "A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia."Acupuncture was no better than sham acupuncture at relieving pain in fibromyalgia. I'm sure you can find others.
Of course, you'll also find studies saying that acupuncture is fantastic for this-or-that condition. Determining which is more likely to be correct would require extensive reading of the original articles - abstracts (like the above) won't let you compare that much.
Oh, another caveat: look out for the "it works on animals, so it cannot be a placebo effect" canard. Since a measured "placebo effect" can include "experimenter bias" and a whole lot of other factors, there's no reason to think that animal studies are immune to placebo effects. |
- Dave W. (Private Msg, EMail)
Evidently, I rock!
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 01/26/2006 : 04:01:09 [Permalink]
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As to the bloodletting, leeches are used for the specific purpose of re-establishing a blood supply to a body part especially after reattachment after an amputation. They aren't just applied randomly for some general benefit. They also use maggots to clean and debride wounds of dead tissue.
I have heard of people with COPD having red cells removed (plasma is reinfused) when their crits get high enough that their blood is literally too thick, though I have never seen a patient have the procedure done.
Other than that, bloodletting is not coming back into medical vogue. It's not like it was useful before and we are now figuring out the benefits. Bloodletting was never of any benefit when used in the past to my knowledge. In fact it is mind boggling how a useless to harmful procedure could have ever been adopted in the first place, let alone carried out for hundreds of years or more. |
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Subjectmatter
Skeptic Friend
173 Posts |
Posted - 01/26/2006 : 06:29:29 [Permalink]
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Yes, and, other than for 'cutting people open', scalpels have fallen into disfavour among medical professionals 
And using them to help restore blood flow seems to me to give them a fairly broad area of use.
Still, I must bow to your superior knowledge of the subject.
I just wish I could find where I read that leeches have pain-relieving effects... I don't know how reliable the source was. |
Sibling Atom Bomb of Couteous Debate |
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