Acupuncture and Stroke: The Globe and Mail’s Epic…Win???

 I guess you could call this post “Part 2” in my examination of science reporting in Canada’s national newspaper The Globe and Mail.

My previous post dealt with the horrific reporting on the supposed link between cell phones and cancer. This time around, I’ll be dealing with an article on acupuncture.

Acupuncture is a traditional Chinese medicine wherein needles are inserted into the skin. The needle insertions are supposed to redirect the flow of qi energy in the body, which subsequently cures whatever ails you. (Check my previous post about acupuncture for a more thorough explanation).

Scientific consensus is that acupuncture offers nothing more than a placebo effect. Yet, most insurance companies continue to cover it (including mine).

So when I saw an article about acupuncture in The Globe, was ready for more fodder for my skeptical mind. But I was pleasantly surprised. Somewhat. Just a little.

The article reports on a recent review of 10 studies looking at acupuncture as a therapy for stroke patients. Not surprisingly, the researchers found no evidence that acupuncture helped the recovery of these patients.

While the article does a good job making this finding clear, it does cloud the issue by talking about the supposed “problems” with studying acupuncture.

One of the most glaring problems confounding the study of acupuncture is that it’s challenging to compare it to anything. While researchers studying the effects of a drug can make a direct comparison by giving some patients the medicine and others a placebo, the same isn’t true of acupuncture. Researchers often give one group of patients acupuncture and use a “sham” therapy on another group, in which needles are inserted at non-acupuncture points in the body.

The problem with that approach is that patients may still get a benefit from the “sham” needles, even if they’re not inserted at the correct points in the body.

The “sham” treatment is the placebo in this type of study, and these sham treatments are often developed with the help of trained acupuncturists. The fact that sham acupuncture gives a similar benefit to the patient as regular acupuncture is not a “problem”, it is evidence. Evidence that acupuncture does not provide any benefit other than a placebo. If the treatment does not provide a statistically significant effect beyond that of a placebo, it is not effective.

Proponents of acupuncture usually try to fog the minds of potential customers by saying that acupuncture cannot be studied by standard “Western” practices; that it should be exempt from scientific study because it is somehow “different”. Even the Globe and Mail article manages to contradict itself on this point:

Dr. Korner-Bitensky said there is no solid evidence showing stroke patients can truly benefit from acupuncture.

“For patients and families I would say [acupuncture is] not where you want to put your major commitment in terms of therapy,” she said.

But there’s another important point that shouldn’t be discounted, Dr. Korner-Bitensky added: Some patients simply believe in acupuncture therapy, and that alone could somehow benefit them.

Sorry, but science is a methodology, not an ideology. “Belief” is not enough. If acupuncture produced a real effect, it should be testable and quantifiable. But it doesn’t.

Now the question always arises at this point: “Even if it is just a placebo, why is that bad? It still makes people feel better. Why can’t we let it continue?”

There are several reasons. The first is that if acupuncture is covered by health insurance, it means that we are all collectively footing the bill for a medical treatment that doesn’t work.

Second, if we allow a treatment which doesn’t work to continue, we open the door for similar treatments and ideology to become mainstream, such as faith healing or homeopathy.

Third, if we continue to allow treatments which don’t work to exist, we run the risk of ordinary people choosing “alternative” treatments, treatments which have been proven ineffective, over science-based treatments that do work.

Finally, acupuncture is not always completely benign. There have been reports of needles being left in, punctured bladders, and there is always the possibility of infection.

So although this Globe and Mail article wasn’t an all-out “Win”, it wasn’t a Fail either. But it does serve to bring up discussion about alternative medicine and the associated dangers of giving them more credit than they deserve.