DRAFT – How Research Standards Can Be False Leading about CAM

There is a simple explanation as to ‘how research standards can be false leading’ about complementary and alternative medicine and their associated therapies. Subsequently the general population and it of acupuncture in the treatment protocols in the USA; researchers and scientist are arguing how the data was reviewed. There is no dispute that there was a positive effect. Keep in mind that in the USA medical system all of the standards of practice must be proven by research and clinical trails before a therapy (pharmacology, surgery, dietary, PT) will be included in protocols which will alleviate any liability of the practitioner from harm to a patient. Hence, in a legal setting the medical practitioner can say “I did it by the book…I did it according to the standards.”

I have provide below is the abstract from a study which reviewed existing research as to the quality of the design of the actual research studies data was analyzed. Make no mistake when you read this abstract – it states that acupuncture had a positive effective. The negative comments were about the mathematical computations used to present the findings of the data.

Bottom Line:  Our government’s job to protect the public from harm requires very high statistical numbers in order to deem a therapy viable to the greater population and not to a specific patient. Each patient is unique and needs to be assessed and treated as such. Hence, many healthcare providers and patients do utilize therapies which have minor or moderate proven researched efficacy because they may be one who is in that statistical group. By the way, medical doctor’s prescribe medications for conditions which have not been approved for treating that condition – this is called ‘off label usage’ and there is some research that shows benefit. Hence, the healthcare provider and the patient make the decision to utilize a therapy without any guarantee of positive results.  See this article on Off Label Use of prescription drugs.

Off-Label Drug Use: What You Need to Know

 

Abstract

BACKGROUND AND PURPOSE:

Acupuncture is a low-risk treatment with purported claims of effectiveness for poststroke rehabilitation. To comprehensively assess the efficacy of acupuncture in poststroke rehabilitation, we conducted a systematic review and meta-analysis of all randomized clinical trials of acupuncture for poststroke rehabilitation.

METHODS:

We searched 7 English and 2 Chinese databases from inception to September 2009. Eligible studies included randomized clinical trials that evaluated the clinical efficacy of acupuncture in adult patients with disability after stroke. We extracted data on trial quality, protocol, and outcomes assessed. A summary OR was calculated based on pooled dichotomous results. I(2) was used to infer heterogeneity and we conducted metaregression to determine if specific covariates explained heterogeneity.

RESULTS:

Thirty-five articles written in Chinese and 21 articles written in English were included. The overall quality of the studies was “fair” and most studies were small (median n=86; range, 16 to 241). The majority (80%) of the studies reported a significant benefit from acupuncture; however, there was some evidence of publication bias. In 38 trials, data were available for meta-analysis and metaregression, yielding an OR in favor of acupuncture compared with controls (OR=4.33, 95% CI: 3.09 to 6.08; I2=72.4%). Randomization, modes of delivery, method of control, study source country, and reporting of randomization may explain some of the heterogeneity observed between the studies.

CONCLUSIONS:

Randomized clinical trials demonstrate that acupuncture may be effective in the treatment of poststroke rehabilitation. Poor study quality and the possibility of publication bias hinder the strength of this recommendation and argue for a large, transparent, well-conducted randomized clinical trial to support this claim and implement changes to clinical practice.

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