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Problems with Chinese acupuncture trials

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A recent systematic review included 44 trials of acupuncture as a treatment of obesity.1 The totality of this evidence suggested that acupuncture is effective and leads to an average weight loss of about 2kg. Compared to pharmacological weight loss treatments, acupuncture seemed equally effective but had fewer side-effects. The authors thus believe that acupuncture may provide a 'new dimension' in controlling obesity.

Why am I not convinced? Most of the studies were in Chinese, and I therefore have to trust the review-authors’ data extraction. They tell us that most trials were of very poor quality. Thirty-seven were open (i.e. not blinded) studies; many were of small sample size; 13 compared acupuncture to no treatment at all and many failed to report all outcome measures. Most importantly, only 16 studies mentioned adverse effects.

Not reporting adverse effects in clinical trials is a serious violation of research ethics, particularly as severe adverse effects and even deaths after acupuncture are well-documented.2

Vis-a-vis such high risk of bias in acupuncture trials, it would be unwise to conclude that this intervention is effective. Considering furthermore that most trials simply ignore adverse effects, it is imprudent to draw positive conclusions about the safety of acupuncture.

Professor Edzard Ernst is professor of complementary medicine at the Peninsula Medical School, University of Exeter

References

  (1)   Sui Y, Zhao HL, Wong VCW, Brown N, Li XL, Kwan AKL et al. A systematic review on the use of Chinese medicine and acupuncture of obesity. Obesity Rev 2012;Feb 1.

  (2)   Ernst E, Lee MS, Choi TY. Acupuncture: Does it alleviate pain and are there serious risks? A review of reviews. Pain 2011; 152:755-764.

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