Acupuncture does not ease Menopause Symptoms
Our latest instance of pseudoscience comes to us from Wake Forest Baptist Medical Center. In a post entitled Acupuncture Used in Clinical Settings Reduced Symptoms of Menopause the authors claim that… well, basically what the title says.
Their findings are going to be published in the journal Menopause in June, and as such I can’t read the actual journal article to look at the actual data yet, but we can gleam some information from the press release.
The study included 209 women ages ranging from 45 to 60 who had not had a menstrual period in three months and averaged four hot flashes per day, all based on self report data. The group of women were split in half: one group would receive acupuncture during the first six months of a year long trial, the second group would receive acupuncture during the last six months.
If this sounds a bit fishy and unscientific, just keep reading. Each participant was asked to keep a daily journal describing their hot flashes and were also given questionnaires to fill out every two months. Lastly, the individuals in both group were allowed to receive up to 20 acupuncture treatments during this time, but were not given a minimum number of treatments to take and were allowed to see “licensed, experienced acupuncturists in the community” or essentially whoever they chose.
Let’s be clear here: all evidence points to acupuncture being nothing more than a placebo. But even if it weren’t, the study design mentioned above is specifically designed to allow for confounds to the point that no respectful journal would even think of publishing this work. I don’t read menopause, it’s out of my field but I have to question the judgement of any editors who would let a study so poorly designed be published, whatever the subject.
Lets pick apart the problems here. First off, although the women were randomly assigned to two groups (that’s good) the gap between treatments (although ostensibly designed to show before and after effects) is a huge problem because the effects of menopause change over time.
But the real issue here is the lack of controls. A properly designed study would have a group of trained acupuncturists hired by the study, performing the acupuncture in the study’s lab, using the same equipment and the same techniques. Furthermore, there’s nothing to compare the findings against because the study didn’t use a sham treatment. Yes half of the group didn’t receive acupuncture in the beginning and the other half didn’t receive it in the end but comparing no treatment is not the same as comparing a real treatment (inasmuch as acupuncture can be labelled “real”) to a sham treatment because this controls for placebo effect.
Except almost all research on the subject indicates that that’s exactly what acupuncture is: a placebo.
A properly designed study would have had women come to the same acupuncturist (or the same team of acupuncturists) for the same number of times (not “no more than 20 over six months, but however many you feel like”). Patients would be assessed before and after, over the course of a few days to see if this had any effect on hot flashes. Biometric measurements would be better, but honestly it’s hard to use such measurements when the symptom being studied can occur hours or days after the treatment.
Why exactly was this study designed so poorly? Well, for one, this is probably the only study design that would have been likely to show a positive result. With so few controls it’s no wonder acupuncture was found to be effective. However, the funding source, the National Center for Complementary and Integrative Health, may have had something to do with it.
What’s depressing however is not that such a poorly designed study was funded. It’s not that it was even published, after all for the right price you could get almost anything published in these predatory journals. The real tragedy here is that news outlets are distributing this nonsense as science without anything close to a critical analysis.
For example: I first found out about this from a website called Psychcentral, one whose RSS feed I had (until this morning) subscribed to.
The article, which is essentially a paraphrasing of Wake Forest’s press release, erroneously claims that the study was funded by the National Institute of Health, and was supposedly, well, I’ll just show you:
Mr. Grohol, this does not pass muster. I doubt whether you read the original press release, or in fact the article that you “scientifically reviewed”.