An INTERESTING follow up to this story… A sharp difference: Study of sham vs real acupuncture appear good or bad depending on how you view it.
The lead author of this acupuncture study complains about “ad hominem” attacks from skeptics. Two skeptical medical blogs give him what’s what.
Here is the abstract.
In September 2012 the Acupuncture Trialists’ Collaboration published the results of an individual patient data meta-analysis of almost 18 000 patients in high quality randomised trials. The results favoured acupuncture. Although there was little argument about the findings in the scientific press, a controversy played out in blog posts and the lay press. This controversy was characterised by ad hominem remarks, anonymous criticism, phony expertise and the use of opinion to contradict data, predominantly by self-proclaimed sceptics. There was a near complete absence of substantive scientific critique. The lack of any reasoned debate about the main findings of the Acupuncture Trialists’ Collaboration paper underlines the fact that mainstream science has moved on from the intellectual sterility and ad hominem attacks that characterise the sceptics’ movement.
Nope. Not close to the mark. There was plenty of substance in the critiques at the time include those from Edzard Ernst, emeritus professor of complementary medicine at the University of Exeter, who said the study “impressively and clearly” showed that the effects of acupuncture were mostly due to placebo. “The differences between the results obtained with real and sham acupuncture are small and not clinically relevant. Crucially, they are probably due to residual bias in these studies. Several investigations have shown that the verbal or non-verbal communication between the patient and the therapist is more important than the actual needling. If such factors would be accounted for, the effect of acupuncture on chronic pain might disappear completely.”
Orac notes that Vickers “doth protest too much”:
The other thing that people like Dr. Vickers seem not to understand is just what an ad hominem attack is. It’s not simply being critical. It’s arguing against an argument based on the person making the argument rather than the argument itself. Were I to say that Dr. Vickers was wrong because he’s an acupuncturist, that would be an ad hominem. I didn’t do that. I deconstructed why I thought he was wrong based on the way the meta-analysis was done, how it was written, and the methodological “issues” I found.
Steve Novella expounds on the critique and what is currently wrong with acupuncture research:
In my critique I pointed out that the results do not show that acupuncture is effective, nor that it is a reasonable referral option. What they characterize as “modest” differences were, rather, not clinically significant. Further, such tiny differences are most parsimoniously explained as the result of researcher and publication bias, two phenomena that are well established in general and specifically within the acupuncture literature. Unblinding alone would be sufficient to explain these results.
Their conclusions are part of a pattern visible within the acupuncture community – attempting to parlay placebo effects into the mirage of a real effect from acupuncture. I commented in my original article that such a conclusion was evidence of pro-acupuncture bias in the authors.
The critiques were scientific and fair. There were some misrepresentation in the Vickers paper (read the two links to find out about them in detail). But my favorite quote was at the end of Orac’s piece: “Dr. Vickers should take a long look in the mirror, as he appears to be projecting his own shortcomings onto the “sceptics’ movement.”
Skeptics: Poking holes in CAM research, calling out the bias. That’s how SCIENCE works.