Placebo effect and acupuncture

Posted By James Flanagan

Interesting article at the New York Times Well blog: “Believing in Treatments That Don’t Work“. It briefly covers when ideology trumps evidence, and touches on a lot of points that could kick start a conversation on the placebo effect.

• Recent press reports detailing the dangers of cough syrup for children have noted that cough syrup doesn’t work. True: No cough remedies have ever been proven better than a placebo, either for adults or children. Yet their use is common.
• Patients with ear infections are more likely to be harmed by antibiotics than helped. While the pills may cause a small decrease in symptoms (for which ear drops work better), the infections typically recede within days regardless of treatment. The same is true for bronchitis, sinusitis, and sore throats. Unnecessary antibiotics are still given to more than one in seven Americans each year for these conditions alone, at a cost of more than $2 billion and tens of thousands of serious adverse medication effects requiring treatment.
• Back surgeries to relieve pain are, in the majority of cases, no better than nonsurgical treatment. Yet doctors perform 600,000 of these surgeries each year, at a cost of over $20 billion.
• More than a half million Americans per year undergo arthroscopic surgery to correct osteoarthritis of the knee, at a cost of $3 billion. Despite this, studies show the surgery to be no better than sham knee surgery, in which surgeons “pretend” to do surgery while the patient is under light anesthesia. It is also no better than much cheaper, and much less invasive, physical therapy.

Some years ago, I toyed with an idea to have a store that would exclusively sell exclusively.  The basic idea goes something like this: Company X makes very important looking bottles and pills, parents give the sugared-water to their children without fear of side effects, and everyone wins.   Of course for this sort of thing to be ethical, this would have to be a more perfect world of only small and non-threatening illnesses.

So, how does this all relate to acupuncture? I’m far from an expert and so will point to someone smarter than me.

One of the many perks of working at Google is something called AtGoogleTalks.  World-famous speakers come and talk at various Google offices around the world. James Randi was a speaker a couple of years ago. His foundation, the JREF sponsors a prize of US$1,000,000 to anyone who can demonstrate evidence of any paranormal, supernatural or occult power or event, under test conditions agreed to by both parties. During the talk, available ,  he responded to a question about his position on acupuncture. The following is my own transcription of the talk (question starts at 41 minutes 0 seconds and the answer starts at 41 minutes and 11 seconds):

[...] In any case, I went to this acupuncture clinic, and I spoke to two gentlemen there, who spoke perfect English, and one of them had been educated at MIT. They explained to me and they said “We have some huge medical problems here in China, and so what we have to do is to sort people out who are just working on imaginary ailments and would just like some personal attention and so we bring them into the acupuncture clinic and we give them moxibustion, acupuncture with incense burning on the end, and bring them consolation and they feel better and they like that they’ve gotten some attention from the government. But we make sure that these aren’t people who require anti-biotic or surgery or anything like that, otherwise we will take care of them.” Now this is a confession from the two guys in charge, the two senior officers that they view that acupuncture didn’t work except on a suggestive basis.[...]

More pondering on acupuncture and traditional chinese medicine later.