Methodological Concerns when Designing Trials for the Efficacy of Acupuncture for the Treatment of Pain
It has taken some considerable time for acupuncture to gain any form of respectability within western medicine. Indeed there is still some resistance from many quarters where acupuncture is still viewed with a large dose of scepticism. Not least is the problem that many of the concepts inherent within traditional Chinese medicine (TCM) do not translate well into western scientific thinking 1. It seems churlish however to discount this modality because of an inability to either grasp its basic tenets or due to perhaps an inadequacy of western science to adequately measure the forces that TCM maintains exists. It must be remembered that TCM has evolved within a framework of pure observation of cause and effect and has anecdotally been shown to be effective over millennia. Adherents may maintain that the inability to provide ‘proof’ does not diminish its usefulness as an effective treatment. It is perhaps this very attitude, which relies on anecdotal evidence rather than scientific evidence, which has alienated many in the western medical profession2. The idea that acupuncture is simply ‘mumbo jumbo’ is however gradually subsiding within the west. This is occurring in the wake of ongoing scientific investigation and credible hypotheses as to its mechanism as well as the emergence of guidelines designed to assist with the design and reporting of trials, both in general and specifically for acupuncture3–5.
KeywordsTraditional Chinese Medicine Placebo Effect Placebo Control Complementary Medicine Transcutaneous Electrical Nerve Stimulation
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