The article uses hyped-up language, such as “significantly reduced” and “significantly relieved,” without citing any numbers to back these claims up. There is little discussion on how benefits were measured or on the limitations of these trials. The story is yet another example of the importance of critical analysis, so that readers can walk away with a more balanced view of cupping therapy.
This story gives a sense of mounting evidence of efficacy of a truly fringe treatment.
Alternative therapies may provide some hope and relief for the millions suffering from chronic pain. Readers need to be able to look critically at “studies” of alternative treatments and have strong journalism help by pointing out flaws and possible harm (besides wasted dollars).
The article mentions that the cost of cupping “varies widely, from $40 to $100 or more for a half-hour session.”
The story cites several studies to support the story’s statement that “a handful of new studies have shown it helps relieve back, neck, carpal tunnel and knee pain.” However, none of the alleged benefits are ever quantified, and that’s our expectation with this criterion. The article uses phrases, such as “more effective on average in relieving pain” and “significantly reduced chronic neck pain.” But what do these mean? And how were these benefits measured? A discussion on some numbers from the trials (how many patients experienced relief, how much pain relief), as well as the research methods to measure benefits, would have been welcome.
Possible harms are never discussed in the story. The story does mention that cupping “shouldn’t be done on pregnant women, people with heart conditions or people with bleeding disorders,” but why not? There are other possible harms, such as spread of resistant bacteria by not properly cleaning instruments.
The story does bring up a limitation in one of the studies – how there is a lack of a control, which suggest that the benefits of the studies may be attributed to the placebo effect. Placebo effect is strong, as we all know. Uncontrolled trials of alternative therapies are next to useless for determining efficacy. Many people feel better just by having someone listen to them for a half hour. If people believe a therapy will work, and pay money for it, it probably will.
But there were more obvious limitations in all of the studies – small sample size and short follow up time. In addition, these types of trials are single-blinded, which may also produce bias. And the story let one researcher get away with citing unpublished data. It’s easy to get away with any claim in that scenario.
The story does not engage in disease mongering.
This one barely squeaks by. There is one independent comment on the trials from David Felson at the Boston University School of Medicine, who said that the lack of a control group “raises questions of whether it is cupping that is really working or if it has a placebo effect.” But more detailed comment on each of the cited studies’ shortcomings and limitations would have been hugely helpful in producing a more balanced view on the benefits of cupping.
The story does not mention any alternatives. What are the traditional treatments for knee arthritis pain and chronic neck pain? Or for pain management in general? A few words about over the counter analgesics, massage, or other proven therapies would have been helpful.
The story mentions that cupping treatment is available through acupuncturists, chiropractors and massage therapists.
The article makes it clear that cupping therapy is not a new approach, as it was “performed traditionally in China and other countries.” Even the headline reads, “Centuries-Old Art of Cupping May Bring Some Pain Relief.”
The story does not appear to rely on a press release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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