Designing a double-blind test for acupuncture

thaiboxerken

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thaiboxerken
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It seems to me that acupuncturists have a very tough excuse to beat when it comes to double blind studies. They claim that only qualified acupuncturists can make acupuncture work . This makes it hard for bias to be factored out. I mean, if the acupuncturist gives sham treatment to a patient, he could be giving the patient subconscious ques that it is a sham.

This brings up the challenge, how can this bias be factored out?
 
Qualified acupunture doctors claim to be able to make standardized diagnoses, by several methods...

That part of the methodology would be a good place to start..getting several acupuncturists to agree on what the exact Qi imbalance is by having them diagnose a sample of patients, and see how often they agree.

'Patient b has an excess of Yang Qi in the TripleWarmer meridian..Patient C has...'

Overcome that obstacle, and then let's see how to test the curative claims.
 
The other thing to do is have to try the "true" accupuncture points vs. random points. The people inserting the needles would not be told which are real and which are fake.

CBL
 
CBL4 said:
The other thing to do is have to try the "true" accupuncture points vs. random points. The people inserting the needles would not be told which are real and which are fake.

CBL
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That was what I took to be Thai's point..if they are acupuncturists, they are going to know the real points...
if they aren't real acupuncturists, then they won't be able to properly insert the needles.
 
I remember something quite recent about a project using retractable needles which were supposed to appear real to the acupuncturist as well as the patient.

Edited to add: I have my doubts about how convincing this could possibly be...
 
What's the point? Which system are you going to use? They all have different diagrams about where your chi flows.
They can stick it.
 
Jeff Corey said:
What's the point? Which system are you going to use? They all have different diagrams about where your chi flows.
They can stick it.
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Not every single acupuncturist uses entirely different meridians and points...There is enough current standardization.

The subjectivity comes more into play with the 'feeling' for 'reedy pulses', and other Qi sensations that can't be externally measured.

And acupuncture does not describe itself as just 'sticking points'...
the needles are eased in until the acupuncturist feels a certain sensation, and then manipulated...so that rules out fake needles or non-acupuncturists in a study.

The question that could be tested, as with polygraphers, is whether or not they can report the same conclusions independently.

If they can't get past that, why try to design a test for efficay?
 
crimresearch said:
Qualified acupunture doctors claim to be able to make standardized diagnoses, by several methods...

That part of the methodology would be a good place to start..getting several acupuncturists to agree on what the exact Qi imbalance is by having them diagnose a sample of patients, and see how often they agree.

'Patient b has an excess of Yang Qi in the TripleWarmer meridian..Patient C has...'

Overcome that obstacle, and then let's see how to test the curative claims.
Click to expand...
I think crimresearch's suggestion is practical.

Acupuncture is also on the rise in different countries. There are Institute of learning teaching the skill to be an acupuncturist in different countries. If they are not a true scientific and credible system, they are bound to start having conflicting standards.

Bringing their conflict to the fore exposes thier weaknesses to the public.

Eg. Acupuncturist in USA say Patient b there is excess of yang qi in the Triple warmer Meridian. But Acupuncturist in China disagree. Then one of them must be wrong.

Having them resolve to straighten up their act, and to maintain a single standard would be good.

If the effectiveness of this single standard "science" of acupuncture is good, then good for the patients.

If however, despite having a "good", "proven" and "standardised" system of diagnosis and treatment via acupuncture, the effectiveness is poor, then
there is only one single "standard" to defeat. NOT loads of charlatants to expose.
 
crimresearch said:
That was what I took to be Thai's point..if they are acupuncturists, they are going to know the real points...
if they aren't real acupuncturists, then they won't be able to properly insert the needles.
Click to expand...

It gets complicated if you want a real doubleblind test of acupuncture. One way of getting close (for the people who see the problem) is to teach two groups of acupuncture students, giving one group the accepted teachings and the other group some other hogwash (placebo). If they could be taught the basics of some simple and not too dangerous acupuncture treatment, you could have acupuncturists giving the treatment without knowing if it was real of placebo.

The trial would have to be quite quick (maybe a weekend) so that the students didn't figure out which group they were in. They would have to be cut off from the rest of the world during the trial and have no prior detailed knowledge of acupuncture (hard to verify 100 %).

This setup is too complex for the Challenge, and would be more at home in a medical journal. Heck, if done properly and with a positive result (for acupuncture) it would go straight into an issue of Nature with some needles on the front cover.

However, acupuncture fails miserably at much weaker attempts at testing. At least i have heard anecdotes of acupuncture failing single blind tests, where the acupuncturist keeps his poker face while placing the needles in the wrong meridian.

I actually use one anecdote to check how much a person knows about the placebo effect and his attitude to acupuncture:

Three people are treated to relax and lower the heart rate. They are all placed in comfortable chairs in quiet rooms.

Person A: Gets acupuncture designed to bring the body to harmony and relaxation and lower the heart rate.
Person B: Gets acupuncture to stimulate the liver or something else unrelated to relaxation, but is told the same as person A.
Person C: Is just told to relax, gets no acupuncture.

What happens to their heart rates?

Well, according to the anecdote, all heart rates drop, A and B drop the same amount, but significantly more than C.

Ririon
 
crimresearch said:
Qualified acupunture doctors claim to be able to make standardized diagnoses, by several methods...

That part of the methodology would be a good place to start..getting several acupuncturists to agree on what the exact Qi imbalance is by having them diagnose a sample of patients, and see how often they agree.

'Patient b has an excess of Yang Qi in the TripleWarmer meridian..Patient C has...'

Overcome that obstacle, and then let's see how to test the curative claims.
Click to expand...
This has already been done - although I can't remember where. They all came up with different diagnoses!
 
Ririon, the problem with your "sham the student" protocol is that acupuncturists claim that over 100 hours of training is needed. Of course, in reality, one only needs a bunch of needles and a gullible patient. However, that would be the excuse they use.
 
Of course those needles are now classified as medical instruments by the FDA, which would probably rule out any experiment using un-licensed non-acupuncturists.
 
But isn't acupuncture based on ancient Chinese medicine, which was pure speculation to begin with? Apparently they didn't want to cut up dead people because these people would need their entire bodies in the afterlife or something.
So, I guess the question is: Why would you need a double blind test for a medical practise that has as much chance of being right as my great grandma's analysis of the internal workings of a computer and is supposed to work on principles that elude modern medicine?
 
H'ethetheth said:
But isn't acupuncture based on ancient Chinese medicine, which was pure speculation to begin with? Apparently they didn't want to cut up dead people because these people would need their entire bodies in the afterlife or something.
So, I guess the question is: Why would you need a double blind test for a medical practise that has as much chance of being right as my great grandma's analysis of the internal workings of a computer and is supposed to work on principles that elude modern medicine?
Click to expand...

Because even a blind squirrel can find a nut once in a while.
 
H'ethetheth said:
But isn't acupuncture based on ancient Chinese medicine, which was pure speculation to begin with? Apparently they didn't want to cut up dead people because these people would need their entire bodies in the afterlife or something.

That's a new one on me.
They certainly didn't have any objection to cutting up people when they were alive....

So, I guess the question is: Why would you need a double blind test for a medical practise that has as much chance of being right as my great grandma's analysis of the internal workings of a computer and is supposed to work on principles that elude modern medicine?
Click to expand...

So that you will be basing your belief that it doesn't work on an objective measure...unlike the anti-vax woos, who don't need no steenkin' proof?
 
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