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Sham/Placebo Acup

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Hi SacredQi, thanks for finding that. Yes, Bobbi, i've read about

this placebo needle in another journal, Archives of Internal

Medicine, 2001, 161, Mar 26. In this they state the introduction of

the Park placebo needle in RCTs (Randomised Controlled Trials)

meausuring the effectiveness of acupuncture in the treatment of

cocaine addiction.

 

They suggest the placebo needle will be better than the Streitberger

needle for use on the auricle. I've spoken to Dr Streitberger about

this and he agrees that his placebo needle can only really be used

on the body and not the ear.

 

However, as Avants, Margolin, Holford and Kosten state in their

reply to Park on his needle, " we note that a needle that does not

penetrate the skin could not properly control for 'needle

insertion', but rather for a patient's preception that a needle had

been inserted. By using a needle inserted into the helix of the

auricle, Avants et al study was able to test differential effect of

needle placement, i.e. the hypothesis that needles inserted into or

near the concha would be more effective than needles inserted into

the helix of the auricle. A sham insertion control would not allow

for this " .

 

What do you think about this?

 

Attilio

 

 

 

SacredQi888@a... wrote:

> In a message dated 11/24/03 1:32:42 PM Eastern Standard Time,

> attiliodalberto writes:

>

> > Hi Bobbi,

> >

> > Have you got a link for that Acupuuncture Today article of sham

> > acupuncture as i can't locate it.

> >

> > Attilio

>

> Not Acupuncture Today but an interesting article

>

> Validating a New Non-penetrating Sham Acupuncture Device: Two

Randomised

> Controlled Trials. Park, J., White, A., Stevinson, C., Ernst, E.,

and James, M.;

> Acupunct Med 2002, Vol. 20(4) p.168-174 <A

HREF= " http://www.medical-acupuncture.co.uk/journal/2002

(4)/168.shtml " >Abstract online</A>

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Chinese Medicine , " Attilio

DAlberto " <attiliodalberto> wrote:

> Hi SacredQi, thanks for finding that. Yes, Bobbi, i've read about

> this placebo needle in another journal, Archives of Internal

> Medicine, 2001, 161, Mar 26. In this they state the introduction of

> the Park placebo needle in RCTs (Randomised Controlled Trials)

> meausuring the effectiveness of acupuncture in the treatment of

> cocaine addiction.

>

 

Do you want purely to restrict yourself to a search for a placebo

needle?

I have real doubts about the ethics of so called placebos. If they

are actually doing nothing they are denying the patient potentially

helpful treatment. On the other hand if they are active they could do

the patient real harm.

When you think of a trial of a surgical procedure you would never

consider a sham operation or drawing lines on the body.

 

As an alternative approach within a double blind trial you could look

at the work by Rosa N Schnyer. Her book Acupuncture in the Treatment

of Depression has interesting methods of using differential diagnosis

to compare effect. (i.e treat a minor syndrome ratehr than the root)

 

On a more radical approach you could question the need for double

blind in the first place. I think it was Steven Birch who put forward

a powerful (to me) argument for double blind trials being

inappropriate in Acupuncture. ARRC conference nov 2000.

 

Hope this interests :) Russ

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<snip>

> When you think of a trial of a surgical procedure you would never

> consider a sham operation or drawing lines on the body.

 

Well actually ...

I ran a google and came up with several sites presenting this.

 

" Study finds common knee surgery no better than placebo "

<http://www.eurekalert.org/pub_releases/2002-07/bcom-sfc070802.php>

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Hi Russ.

 

I don't advocate the use of placebo needles at all. But as it

stands, to get into mainstream healthcare we have to play by their

rules and that means researching acup and herbs within the empirical

RCT frame. This includes double blinded trials.

 

I agree that it's unethical to use placebo trials, but until the

RCT, gold standard method of testing changes we're stuck with it, so

we better make the best of it.

 

Yes, i read a few of Stephen Birch's articles. He also was in the

team that conducted a randomised controlled trials (single blinded)

to test the NADA protocol against a placebo control. It had quite a

few errors in the treatment intervention, i.e. excluding the kidney

point from treatment. Shocking.

 

However, this may all be immaterial, as TCM is based upon syndrome

differentiation and RCTs are based upon standardised treatments, so

the two a real opposites, like Yin and Yang. We may never see the

green light given to TCM via the use of empirical testing. TCM may

become a parallel healthcare model without real quantitative proof

of efficacy.

 

Attilio

 

 

 

" swacres_group " <swacres_group> wrote:

> Chinese Medicine , " Attilio

> DAlberto " <attiliodalberto> wrote:

> > Hi SacredQi, thanks for finding that. Yes, Bobbi, i've read

about

> > this placebo needle in another journal, Archives of Internal

> > Medicine, 2001, 161, Mar 26. In this they state the introduction

of

> > the Park placebo needle in RCTs (Randomised Controlled Trials)

> > meausuring the effectiveness of acupuncture in the treatment of

> > cocaine addiction.

> >

>

> Do you want purely to restrict yourself to a search for a placebo

> needle?

> I have real doubts about the ethics of so called placebos. If they

> are actually doing nothing they are denying the patient

potentially

> helpful treatment. On the other hand if they are active they could

do

> the patient real harm.

> When you think of a trial of a surgical procedure you would never

> consider a sham operation or drawing lines on the body.

>

> As an alternative approach within a double blind trial you could

look

> at the work by Rosa N Schnyer. Her book Acupuncture in the

Treatment

> of Depression has interesting methods of using differential

diagnosis

> to compare effect. (i.e treat a minor syndrome ratehr than the

root)

>

> On a more radical approach you could question the need for double

> blind in the first place. I think it was Steven Birch who put

forward

> a powerful (to me) argument for double blind trials being

> inappropriate in Acupuncture. ARRC conference nov 2000.

>

> Hope this interests :) Russ

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Well you got me there! I had to laugh Thanks

 

Russ

 

 

Chinese Medicine , " Penel Eynde

LeGrand " <hyldemoer> wrote:

> <snip>

> > When you think of a trial of a surgical procedure you would never

> > consider a sham operation or drawing lines on the body.

>

> Well actually ...

> I ran a google and came up with several sites presenting this.

>

> " Study finds common knee surgery no better than placebo "

> <http://www.eurekalert.org/pub_releases/2002-07/bcom-sfc070802.php>

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Penel,

 

This example you quote does not contradict Russ' notion that the

placebo may be 'doing something' :- Patients with osteoarthritis of

the knee who underwent placebo arthroscopic surgery were just as

likely to report pain relief as those who received the real procedure "

 

In this case the surgical procedure may be releasing blockage along a

meridian and preventing stagnation. What do you think ?

 

Sammy.

 

 

 

Chinese Medicine , " Penel Eynde

LeGrand " <hyldemoer> wrote:

> <snip>

> > When you think of a trial of a surgical procedure you would never

> > consider a sham operation or drawing lines on the body.

>

> Well actually ...

> I ran a google and came up with several sites presenting this.

>

> " Study finds common knee surgery no better than placebo "

> <http://www.eurekalert.org/pub_releases/2002-07/bcom-sfc070802.php>

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