Acupuncture trial for fatigue lacks placebo group, is positive

A new study assesses the effectiveness of acupuncture for cancer-related fatigue (CRF) in patients with breast cancer.

Acupuncture for Cancer-Related Fatigue in Patients With Breast Cancer: A Pragmatic Randomized Controlled Trial

We conducted a pragmatic, randomized controlled trial comparing acupuncture with enhanced usual care. Three hundred two outpatients with breast cancer participated. We randomly assigned 75 patients to usual care and 227 patients to acupuncture plus usual care (random assignment of 1:3 respectively) with minimization controlling for baseline general fatigue and maintenance treatment. Treatment was delivered by acupuncturists once a week for 6 weeks through needling three pairs of acupoints. The usual care group received a booklet with information about fatigue and its management.

Conclusion Acupuncture is an effective intervention for managing the symptom of CRF and improving patients’ quality of life.

Another ancupuncture trial, another missed opportunity to do some solid science. These kind of “Pragmatic” accupuncture trials have become common place in recent years. The lack of a placebo group in this trial makes the conclusion that “Acupuncture is an effective intervention for managing the symptoms of CRF and improving patients’ quality of life” a huge overstatement to say the least. Without a proper blinded and placebo controlled protocol the most you can say is that acupuncture might be an effective intervention. The argument from the author that “sham” acupuncture was not appropriate or may be unethical is weak to say the least. Plenty of well controlled well blinded i.e high quality studies have shown that acupuncture has little more than a placebo effect, I think it’s time we let go and started researching things that are more likely to be productive.

I have written a blog post that covers this topic in more detail

  2 comments for “Acupuncture trial for fatigue lacks placebo group, is positive

  1. Step
    November 1, 2012 at 10:15 AM

    Well, this isn’t surprising. In light of the numberous studies showing no benefit over a placebo, CAM procedures like acupuncture are shifting from “healing” to “harnassing the power” of the placebo. So why do you need a placebo? Note the conclusion is managing of the symptoms of CRF, not curing or eliminating CRF; physiologial and psychologial effects of someone paying attention to your symptoms versus DIY. The abstract indicates that it was acupuncture plus usual care versus being given a pamplet to read on usual care. Nothing notes who many of the pamplet readers did what the pamplet recommended. Nore does it compare those who may have indeeded followed the usual care versus the testers acupuncture plus usual care. If I were asked to evaluate my fatigue after a 20 minute nap, I’d rate my fatigue lower too.

  2. LovleAnjel
    November 2, 2012 at 12:10 PM

    Plus the groups are so uneven – only 75 in the non-acupuncture group, compared to 227 in the pointy group? I question how random their assignments actually were.

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