It has been fascinating (and frustrating) watching the cultural shift in attitudes toward acupuncture over the last two decades. It is a study case in how to promote pseudoscience, how to exploit the vulnerabilities in evidence-based medicine, and how effective propaganda can be, even against professionals who should know better. It also demonstrates the dire need for the inclusion of science-based medicine principles when evaluating medical interventions.
A recent Washington Post article by Trisha Pasricha, MD, MPH illustrates nicely the misinformation, and also selective use of information, that leads even some professionals to the wrong conclusion.
She comes to a few dubious conclusions, starting with this:
A 2018 meta-analysis of over 20,000 patients in 39 high-quality randomized controlled trials found that acupuncture was superior to both sham and no acupuncture for back or neck pain, osteoarthritis, headaches and shoulder pain. These outcomes mostly persisted over time — even after 12 months of receiving treatment.
She is referring to the latest Vickers et al systematic review of acupuncture for chronic pain. David Gorski has done a good job of deconstructing these reviews.
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In other words, the evidence is too low quality to conclude that acupuncture works, as desperate as proponents are to say we can reach that conclusion. This is also how different experts can look at the same data and come to different conclusions – it depends on how much you weight different factors, what you consider an “acceptable” study, and how you control for bias.
