In contrast with the competing Reuters coverage, this AP story explained how the study’s methodology differed from that of previous studies, and why the conclusions are likely to be stronger. It also featured comments from experts not involved with study and who are not professionally invested in the practice of acupuncture. Both stories would have done well to include a more careful description of harms. Granted, the meta-analysis in question did not look at harms, but the story could have provided some historical context nonetheless.
The results of many previous studies suggest that acupuncture is as at least as effective, and possibly more effective, than other treatments that are commonly used for chronic pain. However, before it can wholeheartedly endorse a new treatment, the medical community generally wants to know that the approach is also better than a placebo or “sham” therapy. In the case of acupuncture, researchers have had a hard time showing that acupuncture delivered by experts is better than needle pokes delivered at random in a similar setting. Therefore, clinicians who treat pain have been reluctant to embrace what many see as an expensive placebo – i.e., a treatment that works mainly because patients believe in it and want it to work. The new study covered here is important because it suggests, with reasonably rigorous data to back it up, that real acupuncture might have a slight advantage over sham acupuncture when it comes to treating pain. For some clinicians, the results may offer sufficient evidence to recommend acupuncture more enthusiastically.
The story notes that sessions cost $60 to $100 and are covered by some private insurance, but not Medicare.
The benefits are clearly explained by the story: “The patients’ average baseline pain measured 60; it dropped to 30 on average in those who got acupuncture, 35 in those who got fake acupuncture, and 43 in the usual treatment group.” It would have been helpful to include some comparison here. For example, how well do NSAID’s work for these conditions?
The story says acupuncture is “relatively safe,” but doesn’t specify that safety can be improved by selecting licensed practitioners. It also does not mention that acupuncture is associated with rare reports of serious adverse events, most of which seem to occur with unqualified practitioners.
Compared with the competing Reuters piece, the story gives a much better sense that this is just one of many studies that have looked at the usefulness of acupuncture in recent years. And it specifies aspects of the study that may make the conclusions more reliable than previous studies — particularly the inclusion of individual patient data. It also includes a comment from a more mainstream “Western” physician who points out that the results observed in acupuncture studies may not represent the “real world” experience of average acupuncture patients (although this is a deficiency seen in studies of many types of treatments — including more mainstream ones).
The story quotes an acupuncture “skeptic” and the author of an accompanying editorial. It mentions that the study was mainly funded by the federal government, with some additional funding from a non-profit with an interest in alternative medicine.
The story briefly mentions that standard treatments for chronic pain include medications and physical therapy. Close call, but good enough. We would have appreciated a comment about the relative value of these “mainstream” treatments.
The story notes that acupuncture is becoming more mainstream and might be covered in some states under the new health care law. However, a dearth of licensed acupuncturists might restrict availability in some areas, especially rural locations. The story could have mentioned this. But we’ll give it the benefit of the doubt for its general discussion of availability.
The story gives appropriate background on acupuncture research and how the new study differs from previous approaches.
There was enough original reporting that we can sure the story didn’t 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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