Acupuncture "cost effective"

[Deetee]

According to 2 studies for the BMJ (although I cannot link to this for some reason at present.)
The BBC site reports

During the two-year study period, the average total cost of back pain treatment that included acupuncture was £460, compared with £345 for usual care. Although acupuncture was more expensive, when the investigators took into account the health benefits gained from the treatment in terms of quality and quantity of life, they found it was more than worthwhile for the extra cost.

and

The patients who received acupuncture in the study reported lower pain levels and used fewer pain killers than those who received usual NHS care. Although the differences in pain scores between groups were small, the study authors say they represent a "clinically worthwhile benefit" and can be viewed as a "moderate" effect.

How much is due to the placebo effect of acupuncture is evidently unknown, as these are uncontrolled studies.

 

[Blue Wode]

From the BBC site:

Evidence of acupuncture's benefits is largely inconclusive

Which suggests that it’s a rather inconvenient method of treatment when OTC painkillers, a nice hot curry, or rubbing the affected area are likely to be just as effective:

A Maryland study of 570 elderly patients who suffer from arthritis of the knee, found that 6 months of acupuncture modestly reduced pain and improved agility. Six months? Why not take an aspirin? Scientists suggest the needles stimulate release of endorphins. Jalapeno peppers do the same thing. So it wouldn't matter where you stick the needles would it? Then who needs an acupuncturist?

http://bobpark.physics.umd.edu/WN04/wn122304.html

Sampson doesn't actually find acupuncture to be a very dangerous procedure -- although it is invasive, most people seek acupuncture for a known, nonserious disorder -- but he does say it's useless.
"I look at it this way: what if acupuncture didn't exist?" he says. "Would medicine or society be any worse off? If no one knew about it, nothing would change. You would still have ways to apply counter-irritation, through massage or rubbing."
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/08/31/NSGDOIM5RJ1.DTL&type=health

Acupuncture – a critical analysis
Ernst E, J. Intern Med, 2006 Feb;259(2):125-37.

In conclusion, acupuncture remains steeped in controversy. Some findings are encouraging but others suggest that its clinical effects mainly depend on a placebo response.

http://www.ncbi.nlm.nih.gov/entrez/..._uids=16420542&query_hl=8&itool=pubmed_docsum

 

[Deetee]

I am just skimming the studies now, but may have to return to them later as work pressure calls....

Acupuncture = 60 mins
GP consultation = 9.36 min
Physio = 30 mins

Patients in the acupuncture group reported a substantial reduction in concerns about their
back pain that was not observed in the usual care group. A qualitative investigation is indicated to explore the meaning to patients of this reduction in worry, its relation to patient coping strategies, and its implications for the care and management of this group of patients......../..........

Beyond the needling itself, several aspects of acupuncture care in this trial
could contribute to its observed effectiveness, including the individualising of treatment,21 the interaction effect generated by the combination of specific effects,22 the practitioner’s skills at developing
good therapeutic relationships,23 process benefits such as protected time and attention from the practitioner,24 and the widely reported relaxing experience of the treatment itself.​

 

[Asolepius]

How much is due to the placebo effect of acupuncture is evidently unknown, as these are uncontrolled studies.

It was a controlled study, but not blinded and there was no placebo. It is therefore totally impossible to exclude placebo effect from the findings. Indeed the difference was so small that I am surprised there wasn't more placebo effect. I have passed the full text of both papers to a health economist for an opinion - will report back when I get it.

There is a very poor article about this in today's Daily Express. The title is "Acupuncture is best remedy for back pain", when the study never sought to show this. There is a bizarre comment from the lead author Dr Hugh MacPherson -

Until now the evidence base for acupuncture has been weak because no drug company has wanted to spend money on the research.

This shows an astonishing detachment from reality. Why on earth would a drug company want to fund research on a different treatment? It's the sort of thing I get from phone-in insomniacs on late night radio interviews, not from a supposedly rational scientist. The statement is wrong on a second count - as a result of this study the evidence base remains weak, and even MacPherson agrees that the difference is very small.