Acupuncture Works. According to the BBC’s Headline.

January 23, 2009 at 9:30 pm (Alternative Medicine, Bad Science, Placebo) (, , , , , , , , , , , )

The BBC has reported on an acupuncture study. Here, the headline is “Acupuncture ‘works for headaches'”. Oh dear. Smart Bombs has written a cracking post on the reporting of this study in the mainstream media and linked to the Guardian and the BBC reports.

The Guardian ran with the headline and sub-heading “Even ‘fake’ acupuncture reduces the severity of headaches and migraines. {Review of published studies finds improvement in headache symptoms whether or not needles were placed correctly, suggesting a powerful placebo effect}”, which seemed pretty accurate to me. Meanwhile, the BBC went for the headline I quoted above and linked to previous BBC stories with headlines like: “Acupuncture ‘boosts IVF chances’ “; “Needles ‘are best for back pain'”; and “So does acupuncture work?” (if the last one seems more equivocal, bear in mind that it headlined a piece written by Simon Singh). The BBC quote Mike Cummings of the British Medical Acupuncture Society (as well as linking to the BMAS website – and the Research Council for Complementary Medicine – what is it with the BBC and linking to crap websites for ‘balance’?). Cummings gives his point of view as regards the study (“…we still don’t fully understand what is happening when needles are inserted, although these reviews suggest that for certain conditions, it is effective”), but (thankfully) the BBC also managed to quote one of the authors of the paper. Klaus Linde has been involved in some interesting work (particularly in studying the placebo effect and treatments likely to work only by that mechanism – it’s worth checking out his publications on Pubmed) and it was good to see him quoted:

“Much of the clinical benefit of acupuncture might be due to non-specific needling effects and powerful placebo effects, meaning that the selection of specific needle points may be less important than many practicioners have traditionally argued.”

So, essentially, acupuncture may make you feel better – but meridians are bunkum. This is why one should never read headlines or take heed of soundbites. Or, possibly, why one should never use the mainstream press in order to find out about anything. They couldn’t care less about informing you – they simply want to catch your attention. Sadly, it seems they too often decide to do so by providing a misleading headline or soundbite. Sometimes with medacity quotes (also known as ‘claim quotes’). Language Log has more on mendacity quotes [cheers for posting this link on the Bad Science forum, Allo V Psycho - it really is excellent]. As Mark Twain once said “If you don’t read the newspaper, you are uninformed; if you do read the newspaper, you are misinformed“.

More

Live Science has a post on this with one or two moderately amusing comments from acupuncture fans. Background: there is some history in terms of the misrepresentation of research on aupuncture by those preparing press releases, and by those reprinting the press releases on their websites. See this Improbable Science post for more (there’s a whole bunch of posts on there that refer to acupuncture). Hat tip: Somerset Simon on teh Bad Science forums for posting the story.

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4 Comments

  1. Neuroskeptic said,

    “So, essentially, acupuncture may make you feel better – but meridians are bunkum. ”

    They are :) but also we don’t even know that acupuncture does make you feel better, given the fact that RCTs do not measure the “placebo effect” (because people might say they feel better on placebo even if they don’t, because they see this as the expected thing to do).

    this is important because it undermines the argument that “CAM is a placebo but placebos work”. I’m sure they do, in some cases, but we really don’t know how well they work.

  2. jdc325 said,

    “I’m sure they do, in some cases, but we don’t really know how well they work.”
    I’d heard that studies on placebo in terms of experiencing pain had the most impressive results. I would imagine that would make studies looking at acupuncture for back pain or headaches more likely to produce a positive result than a study looking at acupuncture for purposes other than pain reduction (because, if I understand correctly, it is more likely that there would be a placebo response in a study measuring pain). Would we need to do a study comparing acupuncture with sham acupuncture, alongside a control group of “no treatment”, and a group receiving the most effective analgesic treatment we currently have to have a better idea of what’s going on?

    There’s a paper here: Placebo-induced changes in FMRI in the anticipation and experience of pain, that refers to the controversy “regarding whether placebos alter sensory pain transmission, pain affect, or simply produce compliance with the suggestions of investigators” – which seems to be what you are getting at when you write about the expectation that patients will feel better (and the patients themselves responding to this expectation by claiming to feel better). The authors write that:

    “In two functional magnetic resonance imaging (fMRI)
    experiments, we found that placebo analgesia was related to decreased brain
    activity in pain-sensitive brain regions, including the thalamus, insula, and
    anterior cingulate cortex, and was associated with increased activity during
    anticipation of pain in the prefrontal cortex, providing evidence that placebos
    alter the experience of pain.”

    I don’t know if you’ve seen this paper before, but I’d be interested in your thoughts as I know you’ve written a fair bit about fMRI on your blog (bullies have bad brains; the true nature of hatred etc).

    Reading the placebo gene post, I noted a few points – one of which was that “[t]he only way to measure the true placebo effect is to compare placebo-treated people with people who get no treatment at all. This wasn’t done in this study. It rarely is.” – and one was a link to a paper on the “Neural Mechanisms of Hyperalgesic Nocebo Effect” that, funnily enough, included sham acupuncture in the keywords. The authors state that there were “signal increases in brain regions including bilateral dorsal anterior cingulate cortex (ACC), insula” and other regions. (The insula and anterior cingulate cortex were mentioned in the placebo and pain study too – but I’m not sure how much of a surprise that is, as I don’t know how common changes in these regions are or what they actually mean). I don’t think I can access the full paper but the abstract is this one: J Neurosci.

  3. Neuroskeptic said,

    Hey. Sorry for this rubbishly late reply…

    It’s a very interesting paper to be sure – I haven’t looked at the fMRI methodology in detail, but I can believe the result. Certainly, there must be a placebo effect in pain in some cases. Even these guys who don’t really believe in the placebo effect accept that there is an effect in pain!

    But as I’ve just said in this post, there’s a big difference between something that can make you feel less pain over 5 minutes in the lab, and something that’s actually useful in chronic pain…

  4. jdc325 said,

    Thanks for responding NS. Am rushing off now, but will have a read of your links later on. I look forward to reading the case against placebos.

    Cheers!

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