Acupuncture Research Explained

Acupuncture Research Explained

The Acupuncture Research Landscape

Medical research can be super confusing. Its got its own fancy lingo, its own counterintuitive rules, about a bajillion new studies are published each week that we try to keep up with and don’t get me started on stats . . .

If the above description seems fitting of medical research in general, then acupuncture research is probably twice as confusing. In order to join the echelons of Evidence Based Medicine, the acupuncture research community has performed endless contortions to get the complex, nuanced, heterogenous and interactive experience of an acupuncture treatment into a study-able pill-sized double-blind box.

Of course, this practice is backwards: scientific inquiry usually aims to keep the object of study as close to the original as possible and tries to find the best tools to understand it. But due to the primacy of pharmaceuticals in the Western medical context, an intervention is only considered evidence-based if it can be studied by the tools used to study mainstream interventions such a drugs, even if these are the wrong tools for the job.

Acupuncture Research is Way More Positive than You Realise!

The positive side of diligently and repeatedly putting ourselves under the microscope is that acupuncture now enjoys the strongest evidence of effectiveness of any so-called ‘complementary’ treatment and more support than many popular conventional treatments. I hazard to guess that most people in our profession have no idea how positive and strong the peer-reviewed evidence for acupuncture’s practice truly is!

But what is too often not acknowledged, usually out of lack of understanding (especially by researchers), is that when acupuncture studies refer to ‘the intervention’ (as if it were something as straightforward as 500 mg of Ibuprofen) or a ‘placebo control,’ these terms can only ever be metaphorical in the context of acupuncture.

The video below breaks the acupuncture research landscape down into its main parts. This includes studies examining acupuncture’s: effectiveness (how well acupuncture performs in the ‘real-world’), efficacy (how well it performs in controlled settings) and mechanisms (how it works).

  • Studies examining acupuncture’s effectiveness consistently demonstrate that acupuncture is as effective as if not more effective and much, much safer than conventional care for many conditions. (Even skeptics don’t argue with that one)
  • RCTs of acupuncture that are well-designed demonstrate that it is more effective than ‘sham’ acupuncture
  • Oodles of studies have illuminated at least part of how acupuncture works

The video is about 10 minutes long, so make yourself a cuppa and find a comfy chair. Please comment below with your thoughts and your questions and please share it with your interested colleagues and research-minded patients. Enjoy!

Mel Hopper Koppelman is the executive vice-president of the Acupuncture Now Foundation (see full bio).
Mel Hopper Koppelman VP

Posted in Research.

17 Comments

  1. Thanks for making this video. It’s great and very useful, since most acupuncture educations do not go into explaining how proper research is done. Most people will say…that is part of a university study, which has truth in it.

    Also, in a lot of countries the universities only recognize Western medical studies (especially in Europe). I could not do my bachelor in TCM here in The Netherlands because of that. You can do research on acupuncture if you are a Physiotherapists researcher though. I don’t understand that correlation.

    This video is a nice first step for acupuncturist to know what research methods are present. It’s also an invitation to the people that have done (extended)research in acupuncture, to maybe do lectures about this subject. I bet there is a vast interest in that in the worldwide acupuncture community.

    Great job, let’s go monkeys about it. It’s a great year to do that.

    • Hi Heather! Great question.

      All Cochrane Reviews are available for free from the Cochrane Library, which is available online. This is a great resource to be familiar with. (http://www.cochranelibrary.com/)

      Here is the list of the references from the video:
      Linde, Klaus, et al. “Acupuncture for migraine prophylaxis.” Cochrane Database Syst Rev 1.1 (2009).

      Manheimer, Eric, et al. “Acupuncture for treatment of irritable bowel syndrome.” The Cochrane Library (2012).

      Vickers, AJ., et al. Acupuncture of chronic headache disorders in primary care: randomised controlled trial and economic analysis. National Coordinating Centre for Health Technology Assessment, 2004.

      Vickers, Andrew J., et al. “Acupuncture for chronic pain: individual patient data meta-analysis.” Archives of internal medicine 172.19 (2012): 1444-1453.

      Zhang, Zhang-Jin, Xiao-Min Wang, and Grainne M. McAlonan. “Neural acupuncture unit: a new concept for interpreting effects and mechanisms of acupuncture.” Evidence-based complementary and alternative medicine2012 (2012).

      Chung, Joanne WY, Vincent Yan, and Hongwei Zhang. “Effect of acupuncture on heart rate variability: a systematic review.” Evidence-Based Complementary and Alternative Medicine 2014 (2014).

      Anderson, Belinda, et al. “Acupuncture and heart rate variability: a systems level approach to understanding mechanism.” Explore: The Journal of Science and Healing 8.2 (2012): 99-106.

      Takano, Takahiro, et al. “Traditional acupuncture triggers a local increase in adenosine in human subjects.” The Journal of Pain 13.12 (2012): 1215-1223.

      Huang, Wenjing, et al. “Characterizing acupuncture stimuli using brain imaging with FMRI–a systematic review and meta-analysis of the literature.”Deutsche Zeitschrift für Akupunktur 55.3 (2012): 26-28.

      Colquhoun, David, and Steven P. Novella. “Acupuncture is theatrical placebo.” Anesthesia & Analgesia 116.6 (2013): 1360-1363.

      Gorski, David H., and Steven P. Novella. “Clinical trials of integrative medicine: testing whether magic works?.” Trends in molecular medicine 20.9 (2014): 473-476.

  2. A great introductory video Mel, thank you! The head to head studies you discuss (for our students’ benefit!) we also call pragmatic trials – mostly these compare an acupuncture intervention (usually individual – great) in ADDITION to usual care, compared to usual care alone. It would be great to see more ACTUAL head to head studies comparing acupuncture alone to usual/standard care where that’s ethically possible!
    My second point is that I ran the pilot study of (five element) acupuncture for IBS to determine the power calculation for a full scale trial – with only 30 patients we found a highly significant difference, so actually this study was big enough to find an effect, as the effect was huge! So, come on five element graduates, let’s do more to show what we can do 😉
    Final thought – let’s try and get included in long term cohort studies to see if we have the preventive effects we feel we do…
    Many thanks again Mel – excellent video both for patients, new students, and those who didn’t study research as part of their acupuncture qualification.
    Julie

    • Thanks for that discussion, Julie! Yes, ‘pragmatic’ is a helpful word to include here, thanks for that. For these studies, I’ve come across every permutation: acupuncture compared to usual care, acupuncture + usual care vs usual care alone and acupuncture vs a drug.

      In this last category, there’s a great study by Yang and colleagues published in Cephalgia in 2011 comparing acupuncture to Topiramate for migraine prophylaxis where acupuncture completely and utterly romps Topiramate. Definitely, a study worth having handy.

      That’s wonderful about the results of your pilot study. What were you using as a control intervention?

      Your idea about getting included in long term cohort studies is an excellent one and already has my mind whizzing about the practicalities of that. We use them a lot in nutrition research and environmental health. What I’m wondering is who would possibly have data on acupuncture use (are there any suitable datasets lying around for us to get our hands on?) – I know some of the insurance companies are starting to. Because you’re absolutely right, we need to start gathering data about acupuncture’s preventative benefits both from a health perspective but also from a cost-effectiveness angle.

      Thanks again for taking the time to share you thoughts!

      Best wishes,
      Mel

  3. Great, thanks Mel, will look up the Yang study. There’s someone born to be an acupuncture researcher, it’s like Mr Black the coal man 😉

    My control was usual care alone. So definitely worth IBS patients coming for acupuncture too!

    Thought you’d like the cohort study idea too. Some of these things go on for 25-30 years don’t they? The very least that could be done is add in a new question on the annual questionnaire about their acupuncture use in the past and currently. Oh if only I had more time and contacts!!

    Anyway, it’s lovely to be in touch – you’re not far from us at the college in Leamington, do pop in for a cuppa sometime 🙂

    Julie

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