A Ridiculous Headline
A recent study, which I myself blogged about (Acupuncture in Complementary Cancer Care: Easing Joint Pain From Breast Cancer Treatment, 25 November 2013, link) is making it’s rounds in the mainstream media news. The study basically says that both real and sham acupuncture has noticeable effects. Some news outlets reported the study objectively.
“Acupuncture, Real or Not, Eases Side Effects of Cancer Drugs” (New York Times)
However, my eyes roll when I see headlines like this:
“New Study Exposes Acupuncture As Pseudoscience” (Business Insider)
See the difference?
For the second article, in fact, look at the URL. It says “http://www.businessinsider.com/acupuncture-might-rely-on-placebo-effect-2013-12” which suggests that the headline was changed at the last minute. Undoubtedly, the change was to make it more sensationalized.
But let’s analyze how inane this headline is.
One Study
The study mentioned mentions one study, ignoring many others that demonstrate significant differences between sham and real acupuncture. I am aghast at skeptics then skip these “positive” studies by giving excuses such as “oh it’s just one study” or “it’s just a small sample size”. Apparently such limitations do not matter if the study says what they want.
My previous comments on the matter should suffice:
The interpretation of such results will then depend on confirmation bias of the reader. The skeptic will immediately say that acupuncture is therefore useless because it is seemingly no better than sham. Yet, such an attitude forgets that fact that just touching the skin with a needle produces a better effect than nothing at all. On the other hand, The acupuncture supporter will see that acupuncture does work. However, he is now obliged by science to investigate why non penetrative sham seems to have a similar effect to the penetrative acupuncture.
Is it truly placebo?
The Skeptic’s Dictionary (link) defines placebo effect as:
A placebo (Latin for “I shall please”) is a pharmacologically inert substance (such as saline solution or a starch tablet) that seems to produce an effect similar to what would be expected of a pharmacologically active substance (such as an antibiotic).
Note the term “pharmacologically inert”. This means that the placebo should not have any biologic effect on the patient. I would suggest that for something to be pharmacologically inert, it should not have any physiologic effect on the patient’s body. The patient may have some physiologic changes due to the patient’s thinking that he will get better. What then, about treatments that produce physiologic changes that are the CAUSE of the patient’s recovery or symptom relief? That would not be “inert” then.
Acupuncture Placebo Proposal
Research done since the 70s has shown that merely inserting a needle, or merely touching a patient with a needle, has physiologic and biologic effect. A true placebo should have none. I have long proposed that a true acupuncture placebo control should consist of all patients being needled with the same points with real needles, but with some being given naloxone and others being given a sugar pill. Naloxone is known (too many studies to quote) to eliminate the biologic effects of acupuncture.
This way, the study becomes truly double-blinded. The acupuncturist administering the treatment thinks he’s doing the real thing. The patient thinks he’s getting the real thing. Neither knows if naloxone is being given or not. Hence, we can eliminate the biologic effect of acupuncture and whatever results may truly reflect whether acupuncture works or not. Yet, this does not even account for the fact that acupuncture also depends on the manual skill of the acupuncturist. Oh well.
Back to the Point
Going back to the headline, one can see that most journalists are inadequately trained to report on such things. We have seen that just a little research will prove that such headlines are based on information that is easily refuted. One study and they say acupuncture is pseudoscience? What about all the other studies that prove a scientific basis for it? To come up with a headline such as this in this day and age only reeks of sensationalism and bias. This is especially more putrid once we see what’s in the text itself.
“Sham acupuncture” is notoriously difficult to design. Unlike a sugar pill given in place of a real medicine, it’s more complicated to convince patients that they are actually undergoing acupuncture without doing anything that might affect them physically. The authors of the new study caution that even fake acupuncture might yield some unknown physical effect.
Correction, fake acupuncture HAS known physical effects. See my last few paragraphs.
Then look at the next paragraph, with comments by myself in parentheses:
While some studies show a “possible positive effect” when acupuncture is used to treat conditions like lower back pain and menstrual cramps, (so it DOES work) most research on acupuncture is inconclusive (note how the author uses ‘some’ when it’s against his bias and ‘most’ when it’s for his bias. Give us numbers to differentiate ‘some’ from most). Still, while there’s no evidence that energy flows are involved, a placebo effect is not the same as no effect. (emphasis in original)
I must emphasize that an objective reporter should have said “While some studies (show it works)… OTHERS are inconclusive”. That’s objectivity, which we don’t see here.
Conclusion
Reporters and editors sometimes have an agenda. This must be kept in mind when reading their work. Plain and simple. It is most unfortunate that some even take their agendas to the extreme and violate basic rules of journalism. To go from “placebo effect may explain acupuncture effects on aromatase inhibitor side effects” (objective headline)to “acupuncture exposed as pseudoscience” (ridiculous headline) is unforgivable. It is pseudojournalism.