Study casts doubt on Random Controlled Trials in China

[Guest guest]

Well said Hugo, very well said...Tymothy

 

 

> The problem is that *so-called* scientific scrutiny is asking the wrong

questions for the wrong reasons, setting the bar way too high way too early and

changing bar height at its whim.

>

> Thanks, Tom,

> Hugo

>

>

[Guest guest]

I think Stephen Birch's article, " Reflections on the German Acupuncture

studies " , is very germane to this discussion.

http://www.jcm.co.uk/media/cms/File/Birch.pdf

 

He discusses in clear terms where many RCT's of Acupuncture fail.

 

Jamey Johnston, C.Ac

 

Chinese Medicine , " mpplac " <inquiry

wrote:

>

> Study casts doubt on authenticity of outcomes for both TCM and standard

medical studies. Notes positive bias towards treatment investigated and that

issue is not unique to China. Always the grain of salt.

>

> http://www.sciencedaily.com/releases/2009/07/090702184146.htm

>

> For those in the States happy 4th.

> Cheers,

> Michael

>

[Guest guest]

Sung Yuk-ming

 

No offense taken whatsoever. It is very difficult for us all to know who we are

corresponding with on this board. While I don't post often it has always seemed

to me that the conversations are congenial and professional.

 

It has been interesting following the thread as it has revealed some strong

opinions. I particularly liked Timothy's comment although I disagree that the

schools are to blame.

 

Academic institutions, at least accredited ones, move very slowly and for the

most part only when prodded. The question is who should do the prodding?

Interested parties in the U.S. who wish to see the status quo change could start

here, http://www.acaom.org/survey/orig/acaom.info/ The accrediting bodies

create the criteria the schools conform to. If the approved curriculum has holes

that providers recognize upon their entry into the field then it is incumbent

upon them to help change the curricula. The schools will follow they won't lead

because most of them are underfunded and are working to satisfy basic

requirements much less sponsor research. I would encourage my U.S. colleagues to

review the linked document and make their own comments. Do not rely on your

national or state organizations to do it for you.

 

Regards,

Michael

[Guest guest]

the schools are being short sighted. In the end not having good

positive studies will affect all of us including the schools.

 

 

 

400 29th St. Suite 419

Oakland Ca 94609

 

 

 

alonmarcus

 

 

 

 

 

 

 

 

[Guest guest]

Chinese Medicine , " snowmans_shadow "

<snowmans_shadow wrote:

>

> I think Stephen Birch's article, " Reflections on the German Acupuncture

studies " , is very germane to this discussion.

http://www.jcm.co.uk/media/cms/File/Birch.pdf

>>>>>>>>>>>

His article brings up many good issues that are important to understand but non

of which precludes good RTCs. The comments however good as far as the German

studies.

Alon

[Guest guest]

Another article has come to my attention which may be pertinent to the

discussion. Rather than posting a news synopsis which some may misinterpret the

title, some introductory remarks, citation and link to the paper are below.

Something to consider in the messy integration of two very different world

views. We all have our predispositions some declared like Hugo and others less

obvious yet operating in background of our decision making and information

gathering just the same. I will not provide comment nor the authors ending

discussion. Draw your own conclusions. For those who dig in enjoy I found it

enlightening.

 

Regards,

Michael

 

Feeling Validated Versus Being Correct:

A Meta-Analysis of Selective Exposure to Information

 

A meta-analysis assessed whether exposure to information is guided by defense or

accuracy motives. The studies examined information preferences in relation to

attitudes, beliefs, and behaviors in situations that provided choices between

congenial information, which supported participants' pre-existing attitudes,

beliefs, or behaviors, and uncongenial information, which challenged these

tendencies.

 

http://ts-si.orgAlbarracinPB1354555.pdf

 

Journal reference:

 

1. Albarracin; Hart, Inge Brechan, Lisa Merrill, Alice H. Eagly and Matthew J.

Lindberg. Feeling Validated Versus Being Correct: A Meta-Analysis of Selective

Exposure to Information. Psychological Bulletin, Volume 135, No. 4 DOI:

10.1037/a0015701

[Guest guest]

Alon,

 

I agree that RCT's can be developed and designed to fit the

model. As others have pointed out, proper design of RCT's is going to require

adaptation of study design to fit the difference in the paradigm TCM uses.

 

I think Birch provides some in depth illustration of the issues and problems

with current trends in RCT's of Acupuncture. Of particular interest to me is

that once the question of randomization is answered, there is the question of

developing an inert control. Either that or properly defining the control as an

active one.

 

I'll take one instance to illustrate the point of inert over active control and

the lack of proper determination. I think it's telling that the recent and

" infamous " toothpick study that for their control (ie- using a toothpick to

simulate acupuncture) they did one, maybe two, surveys to determine if the

toothpick sufficiently fooled people into believing they were receiving

acupuncture. Great. It fooled people. The researchers however did not bother

to identify prior to the study if the toothpick *stimulation* of acupuncture

points had any physiological effect.

 

Next to proper randomization and peer review, it is an equally huge hurtle to

study design. Without knowing what is and is not causing a response, I think

it's humorous when I read or hear the results of studies showing acupuncture is

" nothing more than placebo " , when in fact the " placebo " has not been determined

to be inert.

 

Jamey Johnston, C.Ac

 

> >>>>>>>>>>>

> His article brings up many good issues that are important to understand but

non of which precludes good RTCs. The comments however good as far as the German

studies.

> Alon

>

[Guest guest]

Michael, I tip my hat to you and all those who devote themselves to the

betterment of Chinese medicine profession. I am sorry that I am occupied at the

moment and have no enough time to review all articles presented and contribute

something productive and constructive. I am very pleased to see such discussions

here.

 

In general, individual practitioners (of all walks) are in lack of financial

resources (MRI, CT etc are expensive, evn mice are costly), manpower, or skills

to conduct decent researches. It is vey difficult, if not impossible for someone

without a fulltime job with very few working hours. That is why the reseaches

are usually released by university faculty or funded by giant phramaceutical

companies.

 

Despite that, fortunately, it is not the only or major path that we Chinese

medicine profession are guided and reinforced to advance our professional

knowledge. We can benefit from the experiences past on to us by our mentors and

literature. There are hundreds of case studies books (from various dynasty)

about Chinese medicine and acupuncture that survived and preserved until today

because they prove themselves they are valuable.

 

We rarely rely upon the 'new discovery' to guide our practice but on the

contrary, I found that all these 'discoveries', especially about the machanisms

of formulation and herbals, reinforce what we have been taught hundreds of years

ago.

 

I know it may be arguable in western mind, ZHANG, Zhong-jing said 'Industriously

seeking anicent teachings and extensively making use of all kinds of formulas'.

In today's language, I think he will not object if I include the sophisicated

MRI, CT, and lab. testings as new knowledge of 'all formulas'.

 

SUNG, Yuk-ming

PhD (Chengdu U TCM), PCEd (U of Hong Kong), BA (Houston),L Ac (HK)