Acupuncture Contortion

It is always remarkable how pseudo-medicine trials just can't bring themselves to report the simple idea that if a drug/procedure has the same outcome as a placebo/sham procedure the drug/procedure does nothing.

A real drug or intervention in the reality-based medical world would ever be approved on the basis of a negative study. But pseudo-medical providers cannot come to grips with the fact that their interventions do nothing.

A case in point: Out of Sweden comes 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.

The title is  very Kellyanne Conway and suggests that acupuncture is better than sham acupuncture..

In the abstract's conclusion, all that many will read in passing, they say

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.

So acupuncture works…?

Nope.

They compared 'real' aka verum acupuncture, sham acupuncture (a telescoping needle) and a control for effects on vomiting and eating during radiation therapy for cancer.

The dense abstract obfuscates the findings:

Results. More patients in the verum ( of 89 patients still undergoing radiotherapy; 82%, Relative Risk (RR) 1.23, 95% Confidence Interval (CI) 1.01–1.50) and the sham acupuncture group ( of 95; 83%, RR 1.24, CI 1.03–1.52) did not need any antiemetic medications, as compared to the standard care group ( out of 63; 67%) after receiving 27 Gray dose of radiotherapy. More patients in the verum ( of 89; 56%, RR 1.78, CI 1.31–2.42) and the sham acupuncture group ( of 94 answering patients; 62%, RR 1.83, CI 1.20–2.80) were capable of eating as usual, compared to the standard care group ( of 63; 39%).

Let me simplify:

Results. More patients in the verum (82%), and the sham acupuncture group (83%) did not need any antiemetic medications, as compared to the standard care group (67%). More patients in the verum (56%) and the sham acupuncture group (62%) were capable of eating as usual, compared to the standard care group (39%).

Simple. Acupuncture is not better than sham acupuncture.

You do not need a 1636 word discussion to try and make a silk purse out the sows ear trying to find efficacy from acupuncture. You need 7.

Acupuncture is ineffective for the conditions studied.

But but but

That the consumption of emesis-related care did not differ between the verum and sham acupuncture group may be interpreted as that verum acupuncture does not affect consumption of emesis-related care during radiotherapy, or that a "floor-effect" was seen.

No no no. It may be interpreted that way. It should be interpreted as doing nothing.

Although at the very end they grudgingly recognize the fact:

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.

But pseudo-medical providers just cannot call a negative study what it is: negative.

Points of Interest 03/11/2017
Points of Interest 03/09/2017

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