A very bad week for professional acupuncturists. Following the two Cochrane reviews last week that exposed acupuncture as ancient Chinese magic -and an elaborate powerful placebo, a fresh from the oven major review published at the British Medical Journal (BMJ)[1], pretty much concludes the funeral.

The report is freely available here. The authors looked at the analgesic effects of both real and placebo acupuncture from thirteen relevant trials (with a little more than 3000 patients in total). They further wanted to identify whether the type of sham acupuncture plays any significant role in the reported effect.

The conclusions of the authors are that a small and clinically irrelevant positive effect of real acupuncture cannot be distinguished from bias due to inadequate blinding in most trials. Further, placebo acupuncture has an even greater effect (!) and seems to be unrelated to the type of “sham” acupuncture used as control.

We found a small analgesic effect of acupuncture that seems to lack clinical relevance and cannot be clearly distinguished from bias. Whether needling at acupuncture points, or at any site, reduces pain independently of the psychological impact of the treatment ritual is unclear.
[...]
What this study adds:

- The analgesic effect of acupuncture is small and cannot be distinguished from bias resulting from incomplete blinding
- The analgesic effect of placebo acupuncture is moderate but very variable as some large trials report substantial effects
- The effect of acupuncture seems to be unrelated to the type of placebo acupuncture used as control

As I was expecting last time, many media outlets distorted the conclusions of the Cochrane reviews, and shamelessly did the same with this review again. Most notably, BBC has failed miserably on both occasions, first reporting that “Acupuncture ‘works for headaches’” and now “Confusion on acupuncture benefit“!

Prof. David Colquhoun (from whom I learned about this latest review) discusses in much more detail the BMJ review and BBC’s below-par reporting in the last couple of weeks in regards to acupuncture results. He has also sent complaint letters to the BBC -still waiting for a response... Update: as a reader has mentioned (thanks Henry), I was mistaken, and it seems that the BBC has responded to at least one of Colquhoun’s complaints -although I could not find which one and what kind of response that was…

Well, not much more to say about acupuncture I guess. A conclusion has been reached: it’s magical woo-woo at its finest! I guess acupuncturists must now find something else implausible to hold on to. I don’t know, perhaps homeopathy? Reiki? Faith-healing? Detox remedies? [...significant amount of time elapses...] Crystal healing? Reflexology? Damn, there are so many woo woo modalities out there it’s difficult to make a choice…

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References:

1. Matias Vested Madsen, Peter C Gøtzsche, Asbjørn Hróbjartsson, "Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups, " British Medical Journal 2009, vol. 338, pp. a3115 [↩]