Electroacupuncture may be effective for depression: study

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

No estimate was provided of what electroacupuncture for depression – nine times over 3 weeks as in the study – would cost.

Acupuncture is almost never covered by insurance.  Each session costs > $100 in the U.S.  So a 9 session course is likely >$1,000.

In contrast, generic SSRI drugs are $4/month and if the patient responds well – about $50 of medication + doctor visits (we could estimate $400) that is covered by insurance.  So out of pocket costs might be < $100.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

No description of the size of the potential benefit – only this vague quote:

“The drop (in depression scores) among the group receiving active treatment was more significant than the placebo group,” said Roger Ng, another researcher in the group, which published their findings in the journal PLoS (Public Library of Science) ONE.

The researchers measured response using 3 scales (2 interviewer-administered and 1 self-administered).  There was only a clear response on one scale (and it looks clinically significant).  One scale showed no response and one was equivocal.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

There was no discussion of harms.

The journal article explained that adverse events (including dizziness, tiredness, nausea, excessive sweating, headache, transient tachycardia, insomnia, vomiting, unsteadiness and somnolence) occurred in at least 5% of the patients in either group and that two patients discontinued due to intolerance of acupuncture stimulation.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

Even the journal article itself raised the following limitations, which the story did not acknowledge:

• the study was conducted in a female-dominated sample with a significant difference in the proportion of female subjects between the two groups. Epidemiological evidence suggests that women are more likely to use complementary and alternative medicine (CAM) and have a higher degree of confidence in CAM efficacy and safety. Whether similar therapeutic effects of (electroacupuncture) could be achieved in male patients needs to be further investigated.
• In addition, as the study was conducted in a single-blind manner, effects mediated by non-blinded acupuncturists could not be excluded.
• although (electroacupuncture) achieved a clinically meaningful, over 2-fold difference in the response rate than the control procedure (19.4% vs. 8.8%), the difference did not reach statistical significance level.
• As long-term effects of (electroacupuncture) were not evaluated in this study and a majority of depressed patients may be required for long-term treatment, long-term antidepressant efficacy of (electroacupuncture) may deserve to be further investigated.

In addition, two thirds of the study subjects had prior experience with acupuncture so this may be a highly selected and receptive sample

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

No independent expert perspective was included.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

No meaningful comparison was given with any other approach to depression.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

There was no explanation of the availability of electroacupuncture. This is certainly an important issue in the USA, which is where we – and presumably many other readers – found the story online.

Does the story establish the true novelty of the approach?

Not Satisfactory

Some research has been published about electroacupuncture for mental illness – including by this same research group – yet the story didn’t hint at any of it.