The Emperors Sham – Wrong Assumption that Sham Needling is Sham

Lundeberg, Thomas; Lund, Irène; Näslund, Jan; Thomas, M.

doi:10.1136/aim.26.4.239

Cited by 97 publications

(78 citation statements)

References 30 publications

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“…This sham intervention-induced effect may result in the difference between verum and sham group not being significant (38). In addition, these controls were often investigated in inexperienced subjects (29,39), so the blinding of this method should be considered when the subjects have had extensive experience in acupuncture.…”

Section: Problems With Study Designmentioning

confidence: 99%

Is acupuncture no more than a placebo? Extensive discussion required about possible bias

Deng

Zhao

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. Numerous randomized controlled trials (RCTs) of acupuncture have been conducted in recent years. The results of several studies implied that acupuncture was only a powerful placebo; however, certain studies demonstrated that verum acupuncture had a greater effect than placebo and the mechanisms between a verum acupuncture group and a placebo/sham group were different. Researchers attempted to investigate the inherent factors that may potentially influence the results of trials. Certain problems observed in acupuncture RCTs also occurred in RCTs in other fields, including insufficient sample size, high dropout rates, inadequate follow-up and randomization. The study of acupuncture is so complex that specific methodological challenges are raised, which are frequently overlooked, including sham interventions, blinding, powerful placebo effects (even stronger than an inert pill) and variations in acupuncture administration. The aforementioned problems may contribute to bias, and researchers systematically attempt to solve these problems. The present review aimed to suggest techniques to design high-quality studies, minimize the placebo effect and optimize acupuncture administration in acupuncture studies. If these problems are addressed, then the results of acupuncture studies may be different.

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Section: Problems With Study Designmentioning

confidence: 99%

Is acupuncture no more than a placebo? Extensive discussion required about possible bias

Deng

Zhao

et al. 2015

Experimental and Therapeutic Medicine

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“…Even though the women's needs for pain relief seemed to have been met to the same degree in the EA group as in the other two groups, we could not rule out the possibility that women in the EA group had received less pain relief than they actually needed. Blinded control interventions in acupuncture research are problematic as it is possible that these interventions have similar physiological effects to acupuncture itself in the activation of the endogenous opioid system [20,21]. For this reason, this study was not blinded and this could have had an impact on the use of other pain relief methods.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture with manual and electrical stimulation for labour pain: a two month follow up of recollection of pain and birth experience

Vixner¹,

Mårtensson²,

Schytt³

2016

Deutsche Zeitschrift für Akupunktur

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Background: In a previous randomised controlled trial we showed that acupuncture with a combination of manual-and electrical stimulation (EA) did not affect the level of pain, as compared with acupuncture with manual stimulation (MA) and standard care (SC), but reduced the need for other forms of pain relief, including epidural analgesia. To dismiss an under-treatment of pain in the trial, we did a long-term follow up on the recollection of labour pain and the birth experience comparing acupuncture with manual stimulation, acupuncture with combined electrical and manual stimulation with standard care. Our hypothesis was that despite the lower frequency of use of other pain relief, women who had received EA would make similar retrospective assessments of labour pain and the birth experience 2 months after birth as women who received standard care (SC) or acupuncture with manual stimulation (MA). Methods: Secondary analyses of data collected for a randomised controlled trial conducted at two delivery wards in Sweden. A total of 303 nulliparous women with normal pregnancies were randomised to: 40 min of MA or EA, or SC without acupuncture. Questionnaires were administered the day after partus and 2 months later.

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“…82 Another hypothesis is that placebo controls are not inert, but may produce specific effects by evoking physiological responses similar to real acupuncture. 83 The use of -for example -superficial acupuncture needling as a control intervention, reflects a lack of the historical knowledge of acupuncture theory and usage. This form of needling has been practiced in Japan for a long time and may well have clinical effect.…”

mentioning

confidence: 99%

Acupuncture in ambulatory anesthesia: a review

Norheim¹,

Liodden²,

Alræk³

2015

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Background: Post-anesthetic morbidities remain challenging in our daily practice of anesthesia. Meta-analyses and reviews of acupuncture and related techniques for postoperative nausea and vomiting (POVN) and postoperative vomiting (POV) show promising results while many clinicians remain skeptical of the value of acupuncture. Given the interest in finding safe nonpharmacological approaches toward postoperative care, this body of knowledge needs to be considered. This review critically appraises and summarizes the research on acupuncture and acupressure in ambulatory anesthesia during the last 15 years. Methods: Articles were identified through searches of Medline, PubMed, and Embase using the search terms "acupuncture" or "acupuncture therapy" in combination with "ambulatory anesthesia" or "ambulatory surgery" or "day surgery" or "postoperative". A corresponding search was done using "acupressure" and "wristbands". The searches generated a total of 104, 118, and 122 references, respectively. Results: Sixteen studies were included; eight studies reported on acupuncture and eight on acupressure. Nine studies found acupuncture or acupressure effective on primary endpoints including postoperative nausea and vomiting, postoperative pain, sore throat, and emergence agitation. Four studies found acupuncture had a similar effect to antiemetic medication. Conclusion: Overall, the studies were of fairly good quality. A large proportion of the reviewed papers highlights an effect of acupuncture or acupressure on postoperative morbidities in an ambulatory setting. However, one should bear in mind that research on acupuncture/acupressure in an ambulatory setting contributes to ambiguous conclusions. Hence, we have addressed some of the issues related to this diversity in acupuncture research.

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The Emperors Sham – Wrong Assumption that Sham Needling is Sham

Cited by 97 publications

References 30 publications

Is acupuncture no more than a placebo? Extensive discussion required about possible bias

Is acupuncture no more than a placebo? Extensive discussion required about possible bias

Acupuncture with manual and electrical stimulation for labour pain: a two month follow up of recollection of pain and birth experience

Acupuncture in ambulatory anesthesia: a review

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