Thank you, this work on Acupuncture is excellent. It shares transparently what is available, how the results were gathered and it is fairly written without emotionally laden drama or judgement. I have downloaded the article to share with the many people who ask me what does EBHC/EBP/EBM say about acupuncture so far, the work also makes it clear that the question is far from answered and that there is work to do.
Best,
Amy
On 8/21/16, 1:43 PM, "Brian Alper MD" <[log in to unmask]> wrote:
How to interpret a sham control for acupuncture, and what that means for recommendations regarding acupuncture. This is fascinating and complex, but how do you make it simple without biasing to one particular perspective?
We synthesized it recently in DynaMed Plus for the topic Acupuncture for chronic low back pain at http://www.dynamed.com/topics/dmp~AN~T906249/Acupuncture-for-chronic-low-back-pain
And summarized this for a quick read in European Journal of Integrative Medicine at http://www.sciencedirect.com/science/article/pii/S1876382016301536
I posted on this through last week, commenting on different stages of the effort each day:
8-15-16: ACUPUNCTURE - How do we know what we know and how well we know it? . https://lnkd.in/e_CDcNe
8-16-16: EVIDENCE AWARENESS needed for good decision-making . https://lnkd.in/eD7d5PQ
8-17-16: EVIDENCE UNDERSTANDING - much more complex than evidence reporting . https://lnkd.in/erMSZGH
8-18-16: CLINICAL PERSPECTIVES - much more complex than guideline reporting . https://lnkd.in/e7rkM-d
8-19-16: SYNTHESIZED GUIDANCE -- when it all comes together ... lnkd.in/e_Yvyae
Brian S. Alper, MD, MSPH, FAAFP
Founder of DynaMed
Vice President of Innovations and EBM Development, EBSCO Health
www.dynamed.com, health.ebsco.com
Twitter: @BrianAlperMD
SYNTHESIZED GUIDANCE -- when it all comes together... lnkd.in/e_Yvyae
-----Original Message-----
From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of healingjia Price
Sent: Friday, August 05, 2016 8:37 AM
To: [log in to unmask]
Subject: Re: A +B versus B design, acupunture and more
What would work would be useful as there are pitfalls mentioned in this design as well as waitlist and most certainly for deciding a sham for Acupuncture. It is not just this form of treatment, a lot of what is used for OT and PT are in this category.
Best,
Amy
-----Original Message-----
From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of jenny whitehall
Sent: Friday, August 05, 2016 8:05 AM
To: [log in to unmask]
Subject: Re: A +B versus B design, acupunture and more
________________________________________
From: Evidence based health (EBH) [[log in to unmask]] on behalf of Juan Gérvas [[log in to unmask]]
Sent: 03 August 2016 09:28
To: [log in to unmask]
Subject: A +B versus B design, acupunture and more
Acupuntura (y otros tratamientos). Diseño de ensayo clínico que lleva a resultados positivos.
Acupunture (and others treatment). A trial design that generates only ''positive'' results.
In recent years, we have seen a plethora of RCTs adopting a design where patients are randomized to receive either usual care (the control group) or usual care plus the experimental treatment. Schematically this design could be depicted as 'A + B versus B'. At first glance, such comparisons may seem reasonable. However, on closer inspection, doubts emerge regarding whether such RCTs are fair scientific tests of the experimental intervention. These doubts originate from the theoretical view that 'A plus B' will invariably amount to more than 'B' alone. Even in cases where treatment A is a pure placebo, its placebo and other nonspecific effects could lead to a better outcome in the experimental group than in the control group. This would be particularly likely if i) the experimental treatment is associated with sizable nonspecific effects, ii) a subjective outcome measure is used, and iii) the experimental intervention 'A' causes a deterioration of the condition being treated.
http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2008;volume=54;issue=3;spage=214;epage=216;aulast=Ernst
Effectiveness of acupuncture for the prevention of episodic migraine. Cochrane. NNTB of 4.
http://www.ncbi.nlm.nih.gov/pubmed/27351677?dopt=Abstract
-un saludo juan gérvas @JuanGrvas
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