Peer Reviewing and Alternative Medicine (was: Spiritual Healing)

[Kuroneko]

No, I really am taking it seriously, I promise.  I guess I just live with a "both, and" mindset rather than an 'either, or" if that makes sense.  I'm seriously right-brained, lol.  From my way of thinking, both experiences are valid and differing experiences means that more research is needed, that's all. 

No, I don't think I would push the old data aside in favor of new data exclusively.  I'd consider both, and how it was used to make their argument.  Maybe they cited both to show the differences and discrepancies between the differnt decades.  Maybe it's the both and mindset again, or maybe the example is a good one because I'm also a college professor and I spent the day grading, but including research from a variety of time periods would indicate depth and breadth on the part of the student, lol.  Researching the history of a topic is just as important as looking at its current state, in my opinion.   

EDIT2:  I'd like to apologize to you.  Acupuncture is clearly an important part of your identity, and I just want to make it clear that it isn't my intention to attack your identity or you as a person in the criticisms that I present.  You seem like a nice person, I don't know you obviously but from our conversation I gather that your heart is definitely in the right place, and I mean you no ill-will.  We have a disagreement on this matter that probably isn't going to be settled, but I just want to make it clear that that alone hasn't led me to be hostile towards you, and even if we don't find any points of agreement I find the intellectual challenge of discussing things like this with an intelligent, articulate person like yourself who happens to be diametrically opposed to me on this issue very mentally stimulating.

Thank you.  I appreciate the apology and the compliment.  I'm incredibly tired and probably overly sensitive, so I apologize for taking things badly.  I wouldn't say that acupuncture is a part of my identity, but it has played a very important role in my life, and without it, I really have no idea where I'd be health wise.  So, yeah, I'm passionate about it.  (Dear god, I just typed, 'I'm passionate about tit,' which is clearly a totally different thing, lol.) 

Obviously, I need to go to bed, lol.

[Jude]

I understand that point of view, and I don't think it's necessarily wrong.  I'm also not 100% sure that acupuncture does nothing -- that would be an unscientific point of view.  It certainly isn't a treatment I want to take away from people who have a strong personal connection to it formed by experience.  My concern is simply that for something which we don't have good, current research supporting it, but its proponents push it real hard and have even gotten it included in many insurance plans in spite of the lack of solid evidence.  However it's definitely much more plausible than something like Reiki, but the general atmosphere of reverence towards alternative medicine is troubling -- whether it's spiritual or not.

I'm concerned that we're expending resources on things that aren't actually helping us in as significant of a way as other uses of those resources could be.

[Kuroneko]

Well, I can tell you that if it didn't work for me, I wouldn't use it, cause my insurance doesn't cover it and it ain't cheap, lol.

Now I really must go to bed, cause the screen is all blurry, lol.   

[Pumpkin Seeds]

Well, actually reading the statement of the journal on their site a reader will note their emphasis on physicians performing acupuncture.  The current chief editor for the journal holds a medical doctorate and was a practicing physician with the military.  Also the journal holds various courses and provides information for physicians to begin merging their practice with the ideas of acupuncture.  The medical journal also states being peer reviewed, which the site states the articles are written for physicians so that would mean the peers are other physicians.  Physicians possess a doctorate in medicine which means they must also conduct, review and partake in research.

Most journals have a bias, a particular point of view that is put forth by the editor of the journal.  That is why anyone that is considering purchase of a particular journal takes note of the chief editor for that particular publication to see if they approve or disapprove.  The bias of the journal presented is obviously in favor of acupuncture.  That does not deprive them of authenticity or a reputation.  As was said, you cannot pick and choose which articles you want to acknowledge as truthful and which you do not based on personal preference.  Should you wish to show articles as false then provide contradictory references.  Do not simply state they are lying, not reputable or “just making that up.”


Also note that the placebo article you put forth does not meet the criteria you just put forth Jude.

[Shadax]

Fair enough Kuroneko. I will not argue with you - though if you have any idea why my own experiences have been so variable then I would like to know. Blaming the one performing it is the easy rout, but it keeps happening. :(

Special pleading.

You pretty much just defined confirmation bias.

Special pleading, after your points? No, just pointing out that the techniques are different. How is a statement of fact - that they work differently - special pleading?

I know what confirmation bias is, I see it every day too. You are also demonstrating it - heck, a lot of people are displaying it here. It is unfortunately a common part of the human mind set. What I was essentially saying is that in order to find a thing that falls into a set parameter, you need the right tools to find it - a bit different from disregarding information that doesn't fit into my beliefs and only looking at the things that do. Don't bother arguing the point, I can see the the different counterpoints that could crop up there too - that it is a way of disregarding tests that have not show results supporting spiritual healing, for example. I know this, but it is not what I am doing. I have already stated at least twice that I want to test this. That is why I am doing this.

As for James Randi, I am not interested in his money. I would much rather go to a university for long term trials.

[Jude]

Well, actually reading the statement of the journal on their site a reader will note their emphasis on physicians performing acupuncture.  The current chief editor for the journal holds a medical doctorate and was a practicing physician with the military.  Also the journal holds various courses and provides information for physicians to begin merging their practice with the ideas of acupuncture.  The medical journal also states being peer reviewed, which the site states the articles are written for physicians so that would mean the peers are other physicians.  Physicians possess a doctorate in medicine which means they must also conduct, review and partake in research.

Most journals have a bias, a particular point of view that is put forth by the editor of the journal.  That is why anyone that is considering purchase of a particular journal takes note of the chief editor for that particular publication to see if they approve or disapprove.  The bias of the journal presented is obviously in favor of acupuncture.  That does not deprive them of authenticity or a reputation.  As was said, you cannot pick and choose which articles you want to acknowledge as truthful and which you do not based on personal preference.  Should you wish to show articles as false then provide contradictory references.  Do not simply state they are lying, not reputable or “just making that up.”

Basically what you're saying is, there's no problem with you affixing the label "peer review" to what amounts to a random organization of practitioners who are universally suffering from a conflict of interest while practicing and publishing "articles" in a scientifically disconfirmed field.  Yeaaah... Despite how amusing it would be to watch you do more mental gymnastics to get out of that one, I think I'm gonna take a pass.  Burden of proof is on you to show they have any credibility whatsoever since they're your witness you basically pulled out of nothing that disagrees with current research which is reliable, so lets see a good reason to trust them.  Show me some evidence that they're in the scientific mainstream.

Also note that the placebo article you put forth does not meet the criteria you just put forth Jude.

Right, the criteria I laid out for acupuncture because acupuncture has recently been retested with better protocols doesn't apply for placebos -- probably because they're different things and the same isn't true for placebos.  It isn't a general rule -- in fact you needn't even consider it if you'd like to take a more nuanced approach and look at each study references point by point, judging the quality of the study individually and determining whether it's admissible or not instead of applying a general shortcut based on current scientific consensus.  But because we probably aren't going to go through 40 sources, I'll give you one source they linked to on the very article we're discussing:  http://consensus.nih.gov/1997/1997Acupuncture107html.htm

Not only does the source itself say "this information is old, don't rely on it" at the top in big red letters, but the original body of work says this:

While there have been many studies of its potential usefulness, many of these studies provide equivocal results because of design, sample size, and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, such as placebos and sham acupuncture groups. However, promising results have emerged, for example, showing efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Further research is likely to uncover additional areas where acupuncture interventions will be useful.

Which is pretty much exactly what I've been saying; past studies haven't been reliable, more research was needed.  And, the current research done after they issued that statement disconfirms acupuncture.

By the way, a lot of articles he gives as evidence of acupuncture being an effective "treatment" are basically about acupuncture relieving pain, which can easily be explained via the placebo effect.  So some of his own "evidence" doesn't point the conclusion he's spelling out.

EDIT:

The medical journal also states being peer reviewed, which the site states the articles are written for physicians so that would mean the peers are other physicians.  Physicians possess a doctorate in medicine which means they must also conduct, review and partake in research.

Got some bad news for you.  The vast majority of people involved in the editing process do not have a PhD, and of those who do?  A lot of them got it from non-scientific institutions.  Check it out if you like:  http://www.liebertpub.com/products/eboard.aspx?pid=233

[Noelle]

Special pleading, after your points? No, just pointing out that the techniques are different. How is a statement of fact - that they work differently - special pleading?

My point was that your spiel on race/ethnicity is patently untrue and doesn't even make sense. You claimed Asians, then Chinese people, and now seem to be retracting that all together -- which is fine, especially in light of Kuroneko's more experienced input in the matter. Even if your belief that race/ethnicity changes things were true, both practices rely on touching on certain bodily points/areas which, by your flawed theory, should vary by race/ethnicity and thus make Reiki less effective/spottier when practiced on non-Japanese people.

But all of that is irrelevant because I think Kuroneko did a fair job assessing it already so we really don't need to rehash it again unless you feel it necessary.

I know what confirmation bias is, I see it every day too. You are also demonstrating it - heck, a lot of people are displaying it here. It is unfortunately a common part of the human mind set. What I was essentially saying is that in order to find a thing that falls into a set parameter, you need the right tools to find it - a bit different from disregarding information that doesn't fit into my beliefs and only looking at the things that do. Don't bother arguing the point, I can see the the different counterpoints that could crop up there too - that it is a way of disregarding tests that have not show results supporting spiritual healing, for example. I know this, but it is not what I am doing. I have already stated at least twice that I want to test this. That is why I am doing this.

Please point out where I am displaying confirmation bias and I will happily retract my opinion. Stating that numerous research results show nothing even remotely concrete in favor of spiritual healing is not confirmation bias, it's making a well-supported claim, which thusfar you have not done much of. If this makes you uncomfortable, I apologize, but I can't exactly reconcile this for you.

You are displaying incredible confirmation bias -- especially by using things you've felt yourself as evidence. You believe it, you've felt it -- you've felt it, you believe it...it's self-fulfilling, even in spite of evidence that consistently shows that there is no actual measurable effect.

Allow me to requote you:

No, what I am saying is that, it is difficult to pick out someone with a high level of skill unless you can sense energy and energy workings yourself - if you cant then one Reiki practitioner is just as good as any other, so you could just pick any old mug out of a crowd for a test, despite the fact that that person many not have the skills your test needs to get a result you can measure. If you want to pick out the ones who can you need someone who can spot them.

You're saying that you can't validate someone's skill level/efficacy unless you already believe in Reiki. That's confirmation bias. People make special exceptions for themselves all the time -- "You can't see ghosts unless you're 'attuned'"...well of course not, because if you're "attuned", you already believe in ghosts. It's already skewed in that direction and is therefore biased. All of your proof is coming internally -- like asking a Christian to prove that Christianity is valid by asking Christian sources. I hope this is clear.

As for James Randi, I am not interested in his money. I would much rather go to a university for long term trials.

If you're interested in a serious study, they're the exact people you want to talk to about conducting a sound and proper double-blind test -- go ahead, read through some of the files. They often even set up test conditions that improve your odds of success and are very fair in negotiating the test conditions. Maybe you're "not interested in his money" (I'm not gonna lie, if I had a strong paranormal belief, I'd very much be interested in that money), but why wouldn't you be interested in their input if they could help you formulate a serious and solid study? If you believe in what you're doing and want to prove something with a study, I would think that would be a tremendous resource to you.

[Jude]

Donate the money to charity after you win it.  The publicity you get will shock the world considering the million dollar prize has gone this long unclaimed.  Or better yet, use the money to fund research -- or start a Reiki institute.  Donate half of it to Elliquiy and you could set this place up for a long life.  You really aren't interested in a million dollars?

I can help you get started.  Before Randi will accept your application you need to be featured by a media outlet in a certain way (I forget the exact rules), and I happen to know a guy who is offering to help any paranormalist meet the media outlet criteria.  Lets get the ball rolling, it'd be awesome to be involved in this.

EDIT:  http://skeptoid.com/challenge.php < that's where you can start.  I really hope you seriously try it.  It'd be awesome to be involved with skeptoid, even only peripherally.

[Brandon]

Wait a minute here, lets be honest about this. James Randi's competition is a complete fraud. Im not one to make accusations like that easily but with the mountain of evidence he has piled up over the years I can come to no other conclusion.

It is well documented that Randi only deals with people that will get him publicity and that he has purposfully manipulated results in his "testing" as well as completely ignoring people that have met every criteria in the first phase of his "testing". It is not and has never been an honest scientificly followed test

[Jude]

I like Randi a lot, but if what you're saying is true, I need to re-evaluate my perspective.  Can you show us some links to back this up?  I was just at his website looking at all of the cases of people who applied and failed, and saw what I believed to be fair methods... So... That's a pretty surprising claim to me.

[Noelle]

Wait a minute here, lets be honest about this. James Randi's competition is a complete fraud. Im not one to make accusations like that easily but with the mountain of evidence he has piled up over the years I can come to no other conclusion.

It is well documented that Randi only deals with people that will get him publicity and that he has purposfully manipulated results in his "testing" as well as completely ignoring people that have met every criteria in the first phase of his "testing". It is not and has never been an honest scientificly followed test

Evidence, evidence, evidence. Like Jude, if there is evidence, I would happily re-evaluate my thoughts on James Randi.

However, the cases he gets, as I linked earlier, are openly documented and the test methods are completely transparent for those who make it that far. As you will see, most people drop out/cease communication before it even gets going.

Just remember that "never" is an awfully strong phrase.

Edit: I should also add that the JREF forums are open and applicants to the challenge are offered a spot there to discuss with members ways to make their tests more sound. Not many conspiracies, to my knowledge, are that inviting to critique, but maybe I've been looking at the wrong ones.

[Jude]

You'd think that if he was unfair and some of these people who applied could be tested and succeed, they'd do it in another venue to dispel the myth that he's trustworthy (if indeed that is a myth).

[Pumpkin Seeds]

Jude, if you cannot understand peer review then please do not use articles.  The journal is reviewed by physicians, that would be people with medical doctorates.  Each article has to meet criteria to be published set forth by the journal and is then open to review, criticism and repeat experiment as required by any scientific article.  That you do not agree with the journal does not matter.  Unless you have evidence to call them liars for making the claim they are peer reviewed, then I suggest you accept the statement.  I do not need to perform mental gymnastics to "get out" of this problem.  I simply need to read and understand the basics of referencing and reading of articles.  As for them being at odds, the physicians obviously do not think so and practice using acupuncture in their medical careers.  I understand that you view the two as opposing, but some certified and trained to practice medicine do not. 

If you are so hot under the collar to understand the seeming contradiction of the practice, I suggest you purchase a subscription to the journal to see for yourself.

[Kuroneko]

Yeaaah... Despite how amusing it would be to watch you do more mental gymnastics to get out of that one, I think I'm gonna take a pass. 

And you wonder why I thought you were being sarcastic before.  That was a pretty unfair and impolite remark.

Shadax, I really have no definitive answer for you why your experiences with acupuncture have been so varied.  However, I will say that it's a very common practice for physicians to attend weekend acupuncture seminars which 'certify' them to practice the method without the kind of substantive training that characterizes multi-year programs certified by the AOBTA (American Organization for Bodywork Therapies of Asia), not to mention pracitioners trained in Asian medical schools, as is the case with my acupuncturist. In fact, it's been the case with all the acupuncturists I've seen, which is three.  They were all trained in China or Korea, two of them were M.D's, as is my current one.  I personally trust them and their education more than the random physician that picks up acupuncture certification because it's trendy.

I spent the night with insomnia thinking about how the opinions posted here would be able to explain the fairly common practice in China of performing surgery while using only acupuncture for anesthesia, so I looked around for about five minutes to see if I could find something that was valid.  Most of the studies pertaining to the practice are in Chinese, but I did find one brief translation of a study performed last year in China.  Mind you, this deals with using acupuncture in conjunction with traditional anesthesia, so it's not quite what I was looking for, but the results are interesting nonetheless.  In it, there were 99 patients, divided into three groups (so it's a pretty small study) and each received variations of treatment.  One group got anesthesia with no acupuncture, one got the meds plus acupuncture at traditional acupoints, and one got the meds plus treatment at non-acupoints.  The translation is from the National Institutes of Health.

http://www.ncbi.nlm.nih.gov/pubmed/20942287

Sorry I couldn’t find more.  I’ll look in Japanese literature, since I at least can read enough Japanese to understand the gist of what’s being discussed. 

I did also find this article from Romanian Neurosurgery about the use of acupuncture for neurosurgery, also from 2010.  This study is really small - only 12 patients - but compares acupuncture and electrical stimulation acupuncture (which I've had - basically, the electro stimulation mimics the usual method of pulsating the needle in a point by hand) in combination with mild sedation.  It's a really interesting article just in general, and includes data from animal studies as well.  Anyhow, here's that link.  At least it’s a good read, lol. 

http://www.roneurosurgery.eu/atdoc/13GheorghitaEvaAnesthesia.pdf

Just totally anecdotally, I thought I’d share just a couple more acupuncture stories.  Laugh at me if you want, but ten years ago I had a very sick cat that I took to the local vets school in Iowa.  There he was diagnosed with kidney failure, severe food allergies, and it was discovered through endoscopy and colonoscopy that his entire GI tract was covered in scar tissue that was full of enophils (basically, allergy indicators to plant material).  The vet school said that beyond steroids and a homemade allergy and kidney diet, there was nothing more they could offer by way of treatment, and sent us home with a 2 months to live prognosis.  Under an agreement with my regular vet, I took him to veterinary acupuncturist, with the understanding that if he didn’t improve in three weeks, I would start the steroids. 

The vet acupuncturist treated him once a week for three weeks, in conjunction with a traditional herbal compound, so we’re not just talking acupuncture here. At home, we made the diet that the vet school gave us and put the herbs into it.  Within the first week the cat had put on weight (he was down to 6 pounds) and was more like his old self in terms of behavior and activity.  By the end of the three weeks, he had gained 2 pounds, had normal bowel movements again, and was obviously healthier.  Acupuncture treatments continued every three weeks for the rest of his life – which was another 2 years, rather than two months.  Animals have no belief system to affect the efficacy of any treatment, so though I’m relating it as a personal anecdote, and I admit that it’s likely that his improvement will be put down to the herbs, which were ingested, I think it does make a case for more investigation into acupuncture’s use. 

I also have a friend that was desperate to have a child.  He and his wife went through the full IVF routine three times, to the tune of about 200 grand.  They had one pregnancy during that time that sadly ended in miscarriage. After that, he said enough, we’re going to see a traditional Chinese medical practitioner like I wanted to in the first place.  This person treated them both with herbs and acupuncture, and within two months they were pregnant.  Their son is now 16.  My own acupuncturist was treating a client that had also gone through IVF several times.  He’d been treating her for about 6 months. She came in last year while I was there to let him know she was pregnant.  She now has a healthy baby too.  He’s not really as skilled with the herbal side of TCM as he is with acupuncture, (I think my knowledge and training as a medical herbalist might actually be better, lol) so I have no idea if he used herbal therapy or not with her. 

Anyhow, just a few more things to think about.     

[Jude]

The journal is reviewed by physicians, that would be people with medical doctorates.

The link I gave you earlier in the post you're responding to here lists their editorial board.  The editorial board is the primary mechanism of review in that journal.  There are people on that editorial board who do not have a PhD or even an MD, which is in direct contradiction to what you have stated above.  Here's an example of one such person.

Michael J. Jabbour, MS, LAc
American Association of Acupuncture and Oriental Medicine
New York, NY

An MS is a master's of science which can be attained in any scientific field.  It is frequently attained in the soft sciences -- unfortunately I can't ascertain what this person received their MS in, but I can tell you that an MS is roughly 6 years of schooling and even a basic MD pre-intern requires 8 years.  LAc?  That's "licensed acupuncturist."  This person is unqualified to be editing, much less be an associate editor.

Part of having a civil debate is to be honest and fair in the logic you employ, not tone alone.  I'll try to control my tone, but in return if we're going to continue this discussion I need you to tell the truth.

And to the larger point of having a board staffed mostly with MDs, MDs can do research but usually do not.  Medical research uses a different skillset than the actual practice of medicine.  Applying treatments is a matter of understanding how to do so safely, effectively, and what those treatments mean based on pre-established medical information.  The process of research requires a sophisticated understanding of the technology of clinical trials, psychological effects that can lead to biases, and the philosophy of science.  It isn't completely unheard of to have MDs who do some research, but when you have an editorial board populated by people who are primarily MDs with little to no PhD training in experimentation itself, that's a huge red flag.

To give an example on how the real scientific community operates in order to illustrate the disparity here, day to day practitioners of medicine do not typically review medical studies.  It's extremely unlikely that your family doctor reads medical journals for the sake of reviewing them and is involved in the peer review process.  Doctors can do case studies and such and present them, but when it comes to being an active, involved member of the scientific community only highly qualified physicians who work at large hospitals and/or teach at universities are actually involved in the academic process of peer review.  And if you glance down the list, you'll see that people on the "Medical Acupuncture" board generally have their own day to day practice, and typically do not work in these usual academic settings.  Another red flag.

Now, is what they're doing "peer review?"  It depends on the definition that you apply.  It's peer review in the sense that members of their organization are writing articles and then their peers in that organization are reviewing it.  However, "peer review" carries a connotation of legitimacy and scientific objectivity with it which this organization does not deserve.  Avoiding conflicts of interest is a baseline requirement to any non-biased experimentation, and the fact that they have so many acupuncturists in their midst is pretty much a dead giveaway that they are not comparable to any reputable journal.  Recall that one of the primary reasons that the Lancet rescinded Andrew Wakefield's MMR study was that they found he was guilty of a severe conflict of interest (he was trying to prove the link between MMR and Autism because he was tied to some lawyers planning a class action lawsuit).

Each article has to meet criteria to be published set forth by the journal and is then open to review, criticism and repeat experiment as required by any scientific article.

But what are those criteria and how do we know that what they're publishing is actually scientific?  The fact that they shamelessly self-promote on the front page of their own website calls their credibility into question.  They don't look like other reliable journals.  A cursory glance shows they're not as qualified as other journals.  They're clearly an organization of acupuncturists who are constantly publishing research that confirms acupuncture works in ways that are not accepted by the scientific mainstream.  As such, I do not understand how anyone can claim that they are a reliable witness at this point.  There is no reason to believe this.

If you'd like to present some examples of why they're credible I'd love to analyze them.  If they are a legitimate organization doing legitimate research, I want to know this.  If acupuncture works and the scientific mainstream is wrong about it, I want to know this too.  I will adjust my viewpoint to fit the evidence, because that is the scientific thing to do.

I think it's fair to ask you, though, what sort of evidence it would take to show you that Medical Acupuncture isn't a reliable source of information so that I can produce it, because if you never set forth a criteria for falsification, there's not even a goalpost to move.  On the flip side, I'll tell you what it would take to convince me of their legitimacy:  a rigorous description of several (lets say 3) well-controlled, legitimate studies that they've published which show scientifically plausible benefits to acupuncture.  Real studies with good sample sizes and statistically significant effects too, and certainly not a meta-analysis of data that other people collected like in your previous post.

As to Kuroneko's latest post, pets are not exempt from the Placebo Effect because it isn't due to the effect of a self-fulfilling prophecy alone.  It's also due to the fact that the adminstration of Placebo techniques results in a greater degree of attention and compassion displayed towards the creature receiving it; in other words, even if Acupuncture did nothing, the act of administering it to your pet still resulted in that pet being treated exceptionally which can have other beneficial effects.  You also didn't control for the change of diet -- which you yourself admit that the vet said could work -- and other lifestyle differences such as helping your pet exercise more, etc.

The bottom line with Acupuncture is real simple:  if it produces solid, beneficial results, then those results should be measurable in a controlled setting even if we don't understand why they occur.  Unfortunately, previous data that I have referenced to on this thread makes it clear that no such thing has ever been documented.  Debate anecdote after anecdote is a flawed, misguided venture because while I can suggest other possible explanations that take away the mysticism from acupuncture, if there was an actual affect, it would be measurable, therefore the chances that there is one fall in line with the validity of those studies.

The good news is, no study (or even series of studies) is ever ironclad, so I can't even say for certain that acupuncture does nothing.  I can say that the evidence shows it's very unlikely that it does anything other than induce a Placebo Effect, and that's what the facts say.  And I don't really have any interest in delving into the murky realm of the subjective and anecdotes beyond that.

[Kuroneko]

No, the vet school said I had to change the diet for the allergies and the kidney disease, not for the scar tissue in the G.I. system.  Sorry, I realize I wasn't clear on that point before. The vet school told me that only option to treat the G.I. stuff was steriods, which I opted not to do. 

I do want to point out that this was a personal experience and not a clinical test.  My only concern here was to help my kitty, not for documenting the effect of acupuncture on animals ;), so yeah, no controls.  And since I've also been treated for inflammatory bowel disease with acupunture with good results, the cat experience is just another example of efficacy in my opinion.  I know it's anecdotal, but I personally can't discount it.     

At least the results in the Chinese and Romanian studies were measurable.

Anyhow, thanks for the discussion everyone. I don't think I have any more to add.   

[Jude]

At least the results in the Chinese and Romanian studies were measurable.

The Chinese study is actually perfectly in line with the previous study I quoted on Acupuncture vs. Placebo Acupuncture.  The only difference is the conclusion that the researchers draw which is erroneous:  instead of saying that the Placebo Effect could be in play and accounting for it, they conclude automatically that the increased benefit in Placebo Acupuncture and Acupuncture is from a genuine effect.  (EDIT:  The p-values of each test group aren't particularly convincing either)

The Romanian Study is absolute garbage.  If you look at their methodology, they mix electroacupuncture, hypnosis, and relaxation techniques.  There's zero control, and the sample size is 12.  The study is completely garbled.

[Pumpkin Seeds]

Actually, a journal is the primary act of peer review of any scientific field.  The entire point of publishing an article is that others interested in the field might see the details of the experiment, conduct a similar experiment to verify the findings and then submit critiques of the experiment.  That is the purpose behind a journal and the publication of articles.  The entire written setup of an article is organized so that a person can quickly review what is being done, design a similar experiment and make their own submissions.  Someone that is able to read through such things is able to readily assess the hypothesis presented, the experiment conducted to test the hypothesis  and the results along with the conclusions of the researcher. 

Now a Masters in Science allows a person to write in a critique an experiment.  Someone holding a Masters in Science may be an editor for a scientific journal may conduct their own experiments and is generally considered to be proficient in their field.  Such people are also considered to be competent in reading, reviewing and researching articles as they have to do this in order to obtain a Masters.  Now, I understand that there is a question regarding what the Master of Science is in, but I do tend to give people the benefit of the doubt as they have one.  A Medical Doctrate requires about 4 years of undergraduate training and roughly four years of medical school training.  Often times holders of a Medical Doctrate are criticized by those with Doctorates of Philosophy (PhD), because they do not go through the years and rigors that they do. 

A Masters of Science is more than qualified to do the task.  Because that person has a license to practice acupuncture does not remove the years invested, the knowledge obtained and the standing of the individual.  Just as I know medical doctors that are priests, nurses that are ministers and so forth.  People do not forsake their beliefs simply because they choose to walk the path of science.  They are also not devalued for their beliefs and their alternative views on a subject. 

Now, I am sure that these words will once more be construed as lies or some holding of my faulty logic.  An example though of how a Masters of Science can be utilized is that the hospital, where I work, has a research department.  The head of this research department holds a Masters in Nursing Science.  Currently my unit has conducted multiple studies including a fall study, infection control study involving telemetry equipment and has helped conducted clinical trials for medications.  These studies were performed, written and submitted by those holding bachelors in nursing science.

Now on the issue of medical doctors not reviewing medical journals, that is correct that not all medical doctors studiously read them.  They are required though to keep up to date on the latest practices, research and upcoming conditions of their field as required by the licensing boards.  So all physicians are familiar with and able to read through journals, critique them and submit their own publications.  Such physicians are also deemed able to remark on the research of others and conduct their own.  There is some humor to be found in the logic here that a medical doctor with their own practice need be discounted from being considered an authority in medical research.  The reason doctors in universities and hospitals conduct much of the research is due to money, not skill or interest.  A physician with their own practice is more than capable of editing journal articles, reviewing submissions and so on so forth.  Their resources might be questioned, but not their knowledge or ability.

Continually this issue of objectivity is brought up, while at the same time saying that good researchers explain their bias.  I would say the journal does a good job stating that they desire to see acupuncture used in medicine.  That is in their mission statement and in the writings they present.  Reviewing their articles will give someone the ability to see if they conducted the experiments with objectivity, not because they have a stated goal.  Now, medical journals and science journals have an understandable bias against alternative medicine.  The case of Emily Rosa, referenced earlier in this discussion, is an example of why not to trust a medical journal if your statements are to be held true.  The school fair project was printed in a major medical journal.  The “experiment” was conducted in violation of standing ethics codes, was published while other experiments that supported Therapeutic Touch that adhere to such scientific principles were denied, and was assisted by two outspoken parents of the eleven year old who are against therapeutic touch.  The journal wanted to ridicule the practice and so showed their bias without even making that bias stated. 

Yet, I will not go about burning medical journals as unscientific.  I am able to review the experiment and see for myself the objectivity.  That is how things are done in the “real scientific community.” 

So aside from finding that the editorial board is staffed with people holding at least a Masters in Science, along with medical doctors holding private practice, I fail to see the issue of accepting the journal aside from this does not match your vision of science. 

The real scientific community does not set out with criteria to have something proved to them or disproven.  They seek the truth.  The medical research community is and should always keep itself open to possibilities that will help improve patient outcomes and provide better care.  Evidence based practice allows us to review our current practices, upcoming ones and find the best route at the time.  Should this doctor be correct with his experiment and he can assist patients receiving head and neck radiation treatment to salivate, then so be it.

So far as I can tell, the only issue with this journal is that you don’t like it.

[Jude]

Could you please answer my question about what evidence I need to present?

[Noelle]

The real scientific community does not set out with criteria to have something proved to them or disproven.  They seek the truth.  The medical research community is and should always keep itself open to possibilities that will help improve patient outcomes and provide better care.  Evidence based practice allows us to review our current practices, upcoming ones and find the best route at the time.  Should this doctor be correct with his experiment and he can assist patients receiving head and neck radiation treatment to salivate, then so be it.

So why don't you defend the countless legitimate studies that have also shown acupuncture to be not everything it seems? Or were those scientists not seeking the truth? What's wrong with their evidence? If you're so keen on defending those who are searching for the truth, it only seems fair.

[Kuroneko]

The Chinese study is actually perfectly in line with the previous study I quoted on Acupuncture vs. Placebo Acupuncture.  The only difference is the conclusion that the researchers draw which is erroneous:  instead of saying that the Placebo Effect could be in play and accounting for it, they conclude automatically that the increased benefit in Placebo Acupuncture and Acupuncture is from a genuine effect.  (EDIT:  The p-values of each test group aren't particularly convincing either)

The Romanian Study is absolute garbage.  If you look at their methodology, they mix electroacupuncture, hypnosis, and relaxation techniques.  There's zero control, and the sample size is 12.  The study is completely garbled.

As, I suspected, nothing can meet your standards.  I don't have any more time to devote to the conversation, nor anything more to add, sorry. 


I'll be staying out of this part of E from now on. 

[Noelle]

I think you're misunderstanding. These aren't whimsical standards made up on the fly, these are pretty baseline requirements for a solid, scientific study. If none of the studies you're citing can meet even baseline requirements, then it's not Jude's standards they're not meeting, they're not meeting the standards of reliable research in general. Perhaps it is not just standards that are too high, but it could also be due to your own lack of thoroughness on your own references.

If you can tell me how testing six variables at once and then concluding that one of them must have produced the outcome is good research, I would be absolutely open to hearing it.

[TheGlyphstone]

Along with the sample size. I don't really have any position one way or the other on the actual acupuncture issue (acupressure is another issue, though), but a 12-member sample pool wouldn't have gotten me a passing in my high school statistics class, I can't imagine it qualifies for rigorous scientific standards.

the Chinese study I can't speak for, since that's a question of bias, but this Romanian study does not look to be worthwhile on statistical grounds alone.

[Pumpkin Seeds]

Well, first we can start with the requested three articles.
http://www.medicalacupuncture.org/aama_marf/journal/vol17_1/article4.html

http://www.medicalacupuncture.org/aama_marf/journal/vol16_3/article2.html

http://www.medicalacupuncture.org/aama_marf/journal/vol16_3/article7.html

http://www.ncbi.nlm.nih.gov/pubmed/18258932?dopt=Abstract

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2805%2966871-7/abstract

As for definitive, absolute evidence to completely refute acupuncture as a beneficial treatment in conjugation with medicine there would have to be a refuting of the experiments done to prove them along with experiments showing a determent to patient outcome.  I would need to have something to show me that my patient would not only fail to improve, but also suffer from having the treatment.

I never said there was anything wrong with their evidence.  Research sometimes contradicts itself.  If science consistently showed the right answer, if everything was always so easy as a single experiment to prove the right answer, then there would be no scientific debate.  The experiment would show the answer and that would be that.  Unfortunately, the real world is not so simple and often times good experiments on the same topic for contradict each other.  Then the process of narrowing the focus, isolating variables and coming up with a new hypothesis begun.

[Jude]

http://www.medicalacupuncture.org/aama_marf/journal/vol17_1/article4.html

There's no control group and the sample size is 23.  The results are also spun in the conclusion considering that objective measurements show no improvement and they still claim the treatment has "subjective and objective" value.

http://www.medicalacupuncture.org/aama_marf/journal/vol16_3/article2.html

At first the sample size here seems much better -- 70 people.  Then you realize they're not doing one experiment here, but 3.  They split people up according to the severity of their disease and then divide those groups further so that there's a control group for each of the 3 subgroups.  In the end, you've got 3 experiments with varying levels of the diseases compared with a control group of 15 people for each group that doesn't even start out on the same base line.  That makes the sample size a lot less convincing by dividing it up.

They don't describe what they did to the control group either, but they mention that they administered acupuncture daily except on weekends to the group getting the acupuncture (7-10 times total).  Visiting a hospital and receiving treatment on a daily basis results in a prolonged Placebo Effect, and considering stress' effect on the respiratory and cardiovascular systems, that certainly affected the data.

I'd like to know what their procedure was for the control group:  did they have them visit the hospital as many times as the groups receiving acupuncture?  Why did they conduct pre-acupuncture procedures on the control group (measuring electroconductivity in an attempt to find "meridians") and what did they tell the control group that they were doing during that time?  Why wasn't there a placebo group?

This study is really poorly done.  As previously said, it's 3 in one, the sample sizes are low, the baseline for the groups isn't equal to begin with, and a lot of their methodology is quite frankly baffling.  Despite that, in one of their three groups they found no benefit and their P values weren't that impressive.  You'd think this would lead to a somber conclusion that admits the faults of the experiment and that acupuncture's benefits are still undetermined, but no:  "Acupuncture has statistically significant positive effects on airway permeability and on pulmonary hemodynamics in COB patients. Acupuncture improves contractility and mobility of the diaphragm in COB patients at all stages of the disease. Before starting acupuncture treatment, it is reasonable to complete Ryodoraku diagnostics for individualization of acupuncture protocol and right point selection."

I like the paragraph before that too; there they basically say that they need to determine on an individual basis whether to apply the acupuncture or not for the group that it showed no objective benefit for.  So the science comes up negative and they still use the same alternative medicine shtick?

http://www.medicalacupuncture.org/aama_marf/journal/vol16_3/article7.html

...10 patients.  Not even gonna read this one.

As for the other links, my question was what it would take to convince you that Medical Acupuncture wasn't a reputable source of information; I was referring to the publication itself.  Those links are not from Medical Acupuncture.  And my question remains unanswered.  Requoted for the sake of convenience:

I think it's fair to ask you, though, what sort of evidence it would take to show you that Medical Acupuncture isn't a reliable source of information so that I can produce it, because if you never set forth a criteria for falsification, there's not even a goalpost to move.  On the flip side, I'll tell you what it would take to convince me of their legitimacy:  a rigorous description of several (lets say 3) well-controlled, legitimate studies that they've published which show scientifically plausible benefits to acupuncture.  Real studies with good sample sizes and statistically significant effects too, and certainly not a meta-analysis of data that other people collected like in your previous post.