Trick or Treatment—The Undeniable Facts about Alternative Medicine (Electronic book text)

Conditions ‘for which acupuncture has been proven — through controlled trials — to be an effective treatment’ — this included twenty-eight conditions ranging from morning sickness to stroke.

Conditions ‘for which the therapeutic effect of acupuncture has been shown but for which further proof is needed’ — this included sixty-three conditions ranging from abdominal pain to whooping cough.

Conditions ‘for which there are only individual controlled trials reporting some therapeutic effects, but for which acupuncture is worth trying because treatment by conventional and other therapies is difficult’ — this included nine conditions, such as colour blindness and deafness.

Conditions ‘for which acupuncture may be tried provided the practitioner has special modern medical knowledge’ — this included seven conditions, such as convulsions in infants and coma.

The 2003 WHO report concluded that the benefits of acupuncture were either ‘proven’ or ‘had been shown’ in the treatment of ninety-one conditions. It was mildly positive or equivocal about a further sixteen conditions. And the report did not exclude the use of acupuncture for any conditions. The WHO had given acupuncture a ringing endorsement, reinforcing their 1979 report.

It would be natural to assume that this was the final word in the debate over acupuncture, because the WHO is an international authority on medical issues. It would seem that acupuncture had shown itself to be a powerful medical therapy. In fact, the situation is not so clear cut. Regrettably, as we shall see, the 2003 WHO report was shockingly misleading.

The WHO had made two major errors in the way that it had judged the effectiveness of acupuncture. The first error was that they had taken into consideration the results from too many trials. This seems like a perverse criticism, because it is generally considered good to base a conclusion on lots of results from lots of trials involving lots of patients — the more the merrier. If, however, some of the trials have been badly conducted, then those particular results will be misleading and may distort the conclusion. Hence, the sort of overview that the WHO was trying to gain would have been more reliable had it implemented a certain level of quality control, such as including only the most rigorous acupuncture trials. Instead, the WHO had taken into consideration almost every trial ever conducted, because it had set a relatively low quality threshold. Therefore, the final report was heavily influenced by untrustworthy evidence.

The second error was that the WHO had taken into consideration the results of a large number of acupuncture trials originating from China, whereas it would have been better to have excluded them. At first sight, this rejection of Chinese trials might seem unfair and discriminatory, but there is a great deal of suspicion surrounding acupuncture research in China. For example, let’s look at acupuncture in the treatment of addiction. Results from Western trials of acupuncture include a mixture of mildly positive, equivocal or negative results, with the overall result being negative on balance. By contrast, Chinese trials examining the same intervention always give positive results. This does not make sense, because the efficacy of acupuncture should not depend on whether it is being offered in the Eastern or Western hemisphere. Therefore, either Eastern researchers or Western researchers must be wrong — as it happens, there are good reasons to believe that the problem lies in the East. The crude reason for blaming Chinese researchers for the discrepancy is that their results are simply too good to be true. This criticism has been confirmed by careful statistical analyses of all the Chinese results, which demonstrate beyond all reasonable doubt that Chinese researchers are guilty of so-called publication bias.