Talk:Acupuncture

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[edit] References

[edit] Citing individual studies

Some recent edits (see the cumulative results of several recent ones) have added particular studies from the literature. Those are certainly considered good sources on WP, but neither can we cite (or properly weight) every single one, and there are a lot of them, with equivocal and sometimes contradictory results. Per WP:MEDRS I think we should focus mainly on good review articles, practice guidelines, position statements from respected sci bodies, and other such sources. Accordingly, I might end up outright deleting some, especially in cases where those studies have been cited in a review-type source that's already in the article. --Middle 8 (talk) 02:34, 25 March 2009 (UTC)

Done. [1] Also removed extraordinary claim [2] and followed up on suggestions above to bring more balance to the lead re efficacy. [3] regards, Middle 8 (talk) 03:06, 25 March 2009 (UTC)

[edit] Acupuncture detoxification

Acupuncture detoxification should probably be merged into this page - it's a stub, and right now there are three references, including a Cochrane Collaboration review, that there is no evidence to support it. There's the usual gushing endorsements from industry publications, but the reliable sources indicate it's bunk. Thoughts? WLU (t) (c) Wikipedia's rules:simple/complex 10:04, 27 May 2009 (UTC)

Bad idea, given that there are ample sources in the article, and this article is already long enough that we're gonna have to spin more stuff off, if anything. Of course, if you keep deleting stuff [4][5], eventually there will be little to merge, and the point will be moot -- but that strikes me as dubious logic, at best.
BTW, you make the classic error of assuming that a lack of evidence means it's bunk; it might be, but it also might be that it's not, and the evidence base is simply weak (in terms of conclusive evidence for or against efficacy). Cochrane says as much [6][7]. We might follow their judicious approach, eh? Nobody (well, not me anyway) is advocating that we ignore or contradict Cochrane; the stuff you'd like to delete doesn't do so. More on that article's talk page.
A final note: whether or not something is proven to work isn't the criterion for whether it should be in WP. Astrology and homeopathy don't work, but no good encyclopedia would disregard them. --Middle 8 (talk) 10:33, 27 May 2009 (UTC)
The article is very short, and the topic unsubstantiated. And in fact, it's pretty conclusively demonstrated it doesn't work pmid = 19004596 (which you have linekd to) "Auricular acupuncture had no effect upon withdrawal severity or craving when provided as an adjunct to a standard methadone detoxification treatment. The results are consistent with the findings of other studies that failed to find any effect of acupuncture in the treatment of drug dependence. The failure to find any clinical gains from the adjunctive use of auricular acupuncture during detoxification from opiates raises concerns about the widespread acceptance of this intervention." A topic's substantiation via scientific testing means we give due weight to the best experts. WLU (t) (c) Wikipedia's rules:simple/complex 10:47, 27 May 2009 (UTC)
The nuanced passage from Cochrane that I had in mind was this:
  • "The studies had a number of problems with the way their results were reported. The authors conclude that there is no evidence that any form of auricular acupuncture is effective for treating cocaine dependence. They recommend that better research be done, since it was difficult for them to draw conclusions from the few available studies."[8]
See? They're not making the claim (which requires a burden of proof) that acu doesn't work; they're saying evidence doesn't support it and the evidence base is itself poor. Now please explain why giving due weight to those experts (and to Bearn et. al. 2009, to which I mistakenly linked, intending to link to Cochrane's cocaine review) means not having an article on the subject, particularly in light of what those same experts say about homeopathy? Efficacy is not the same as notability. (And even if it were, surgery would be screwed if the criterion for efficacy were whether or not meta-analyses of double-blinded placebo-controlled RCT's clearly showed efficacy. Placebo surgery is harder than placebo acupuncture, but both are far less trivial than a placebo pill. Bit of a double standard, imo.) --Middle 8 (talk) 11:13, 27 May 2009 (UTC)
  • Support merger there are better candidates for spin off than this. Verbal chat 12:26, 27 May 2009 (UTC)
  • Merge (nominator) - it's a short page and given the lack of evidence of efficacy and evidence of lack of efficacy, it's unlikely to get longer without undue emphasis on the cherry-picked trials that do support it. The page is not destroyed or contributions erased, it would be a section in this page with acupuncture detoxification perhaps as a subheading or as a single sentence. WLU (t) (c) Wikipedia's rules:simple/complex 12:55, 27 May 2009 (UTC)

[edit] Someone removing edits because they don't agree?

I was adding a source from an article I've read that has several references for their sources, but another member keeps undoing my edit. Granted, the first time, I hit "save page" instead of "show preview" (I'm still learning some of the linking codes here), so the source didn't show then and he undid my edit before I could load the screen enough to edit it (and no source is a valid reason for removing it, although it was premature). When I put it on again with the correct citation, he removed it again within a few minutes because it "wasn't a reliable site". Why remove a page with valid sources for the information just because he doesn't think it's a good enough site? It's properly cited and verified... Wouldn't that be against Wiki's guidelines to just remove content because you don't think the sources are good enough or am I missing something? Burleigh2 (talk) 20:30, 28 May 2009 (UTC)

Maybe I misread, can you please place the reference here. I didn't question it as a "reliable site" but as a WP:MEDRS - a reliable source for a medicine related article. There is also the lower bar of WP:RS - a reliable source. These are wikipedia standards for references. I don't think NaturalNews.com meets these criteria. BTW: Thanks for assuming faith with my first edit, but you should have done with the second too :) WP:AGFVerbal chat 20:38, 28 May 2009 (UTC)

Sure, the website is at http://www.naturalnews.com/025057.html and they list several references (including the Oxford Journal and ScienceDirect.com, which also has their references and abstracts from reputable sites) at the bottom of the page. I don't know how much of a reputation (or lack thereof) that NaturalNews.com has, but the references that each of it's citations list are legit. I am still new to editing Wiki and didn't want to start an "edit war" because I misunderstood something. Burleigh2 (talk) 20:47, 28 May 2009 (UTC)

What we should do is find the article the news story is based on, and bring that here for discussion. Thanks for understanding and not getting upset! I'll have a quick look now but it's late where I am. Verbal chat 20:48, 28 May 2009 (UTC)
Here is the study: doi:10.1016/j.bbr.2008.04.020. I'm not sure if it's already discussed to be honest. I'll have to check later, or maybe another editor knows? Verbal chat 20:52, 28 May 2009 (UTC)
That study appears not to be used (else is cited in a pretty screwy format). NaturalNews is really not a Reliable source in the sense of that guideline, as they are not exactly noted for their objectivity. The Reliable sources noticeboard might disagree, but I highly doubt it. I need to read the full study first, but it looks like it could be cited under Neurohormonal theory. - 2/0 (cont.) 04:37, 29 May 2009 (UTC)
The news release can't be used as a source per Wikipedia:MEDRS#Popular press, and the article itself should be reviewed to make sure it is not undue weight to cite it. WLU (t) (c) Wikipedia's rules:simple/complex 15:07, 29 May 2009 (UTC)

That seems more than odd that a study conducted at Harvard University isn't good (unbiased or legit) enough to list for Wikipedia. Is it the study itself or is the the outlet that is reporting on the study? Burleigh2 (talk) 15:39, 29 May 2009 (UTC)

Just being from Harvard doesn't mean it's a great study. We have reviews which pool data from many studies, at it depends on size, methodology, conclusions, peer review, journal prestige... etc. etc. I'm afraid right now I don't have time to review the paper myself. We can't rely on the news report as they are not from WP:RS news outlets, and news reports fail WP:MEDRS. It's better not to rely on single studies too, especially if they go against the reviews. WP isn't for cutting edge research, generally. Thanks, Verbal chat 16:38, 29 May 2009 (UTC)
Part of the issue is undue weight. We are expected to document the current scientific consensus from the best possible resources. As it says here, the best sources are secondary, summarizing broad areas of research and up-to-date proof. Single studies can be errors, outliers, have faked data, and generally don't represent scientific consensus. It also prevents pushing from people with conflicts of interest and generally strong beliefs, who are willing to cherry-pick data and studies to support their views while ignoring dissenting and objections by other readers. WLU (t) (c) Wikipedia's rules:simple/complex 18:40, 29 May 2009 (UTC)

[edit] Imbalanced, unfair article

Being imbalanced and factual, you could say writing evidence based, doesn't mean being nice. The fact that there is no scientifically plausible method for accupuncture to work is orders of magnitude more important than some 'crazy' ideas ("Many hypotheses have been proposed to address the physiological mechanisms of action of acupuncture").

Wikipedia is made for the lay person, is it not? And the lay person has to have it explained to them, what this scientific lingo means, otherwise one might easily be under the impression that there is a genuine scientific controversy about the hypothesis, when there isn't: accupuncture simply proved to be false by the scientific method. That should be properly emphasized.

Let's not be so open minded that our brains fall out. —Preceding unsigned comment added by 88.130.67.75 (talk) 07:21, 1 June 2009 (UTC)

If you're right about the state of scientific consensus, I'm sure you can find a suitable source. Otherwise we'll have to do the best we can with the sources we have. The Cochrane Collaboration is an outstanding source for reviews; have a look at the one for nausea published in 2009, using acupoint P6. Summary: "P6 acupoint stimulation prevents postoperative nausea and vomiting with few side effects." A review for chronic headache: "CONCLUSION: Needling acupuncture is superior to sham acupuncture and medication therapy in improving headache intensity, frequency, and response rate." These are from some of the best WP:MEDRS's out there. (I'll update the article with 'em presently). Pubmed and Cochrane have lots more reviews of acu for different conditions, with conclusions ranging from + to -, and virtually all calling for more study (in large part because the issue of sham acu as a control isn't settled). Oh, here's something on mechanism. regards, Middle 8 (talk) 01:51, 3 June 2009 (UTC)
Yeah, it's clear that no one should come to Wikipedia for medical information, but too many do so. There are a few poorly designed studies that may show a placebo effect, but otherwise, there is simply no scientific controversy about this procedure. All clinical research, save for the badly designed ones, show it does nothing. SciMedKnowledge (talk) 18:54, 2 June 2009 (UTC)
Again, if that's true, then you should have no problem coming up with definitive references that refute the others we have and finally settle the issue. I would discourage edits like this, i.e. changing text to meet your preference but departing from the original source cited. If we find the best sources and stick close to them, it should be pretty easy to keep the article up to snuff. The citations I gave above on nausea and headache refute your final assertion. regards, Middle 8 (talk) 01:51, 3 June 2009 (UTC)
What a fanciful reinterpretation of the evidence. You are, I suppose, perfectly at liberty to reject the views of organizations like the WHO, and to believe whatever you like in your private life, but it has been the view of the medical establishment for many years now that acupuncture works for a number of conditions and that is really what the article must say. I know it is hard when one's beliefs clash with accepted scientific knowledge but wikipedia is not the place to take up this argument. 72.14.195.225 (talk) 19:57, 2 June 2009 (UTC)

Funny you should say that. Sorry to interject, but the "medical establishment" also used to believe that using Mercury to fight illnesses and leeches to encourage circulation were the best things to do, too. Just because the medical establishment follows a regimen doesn't always mean it's healthy or good and there have been hundreds of examples over the past couple centuries, plus several that have happened just in the past few years (recalled drugs that were commonly prescribed, changing medical procedures, etc). I'm not saying that Acupuncture will be accepted by the WHO anytime soon or at all, but the "medical establishment" has proven that it's not infallible. Burleigh2 (talk) 18:30, 9 June 2009 (UTC)

Not to mention the British Medical Association and several Cochrane reviews... the WHO used a coarser sieve than other reviewers, but they're obviously an "internationally reputable expert bod(y)" and a valid WP:MEDRS. --Middle 8 (talk) 01:51, 3 June 2009 (UTC)
Actually, most MEDRSes have highly criticised the WHO report. We shouldn't use it, when much better, more recent sources are available. Shoemaker's Holiday (talk) 02:25, 3 June 2009 (UTC)
No, we should do right by both NPOV and VER and (a) keep it (it's not that old) and (b) work in good sources that criticize it (keeping in mind WP:PARITY: right or wrong, WHO is a heavyweight as sources go, so WP:NOTTRUTH and all that). BTW, I checked Pubmed, and couldn't find much about the WHO and acu, so which MEDRS's do you have in mind? regards, Middle 8 (talk) 04:37, 3 June 2009 (UTC)
The LAncet, one of the biggest names in medicine, took it and a draft report on homeopathy apart in an editorial: doi:10.1016/S0140-6736(05)67159-0. This is NOT a non-controversial report, and must not be presented as such. Shoemaker's Holiday (talk) 02:16, 4 June 2009 (UTC)
I'd agree. That's a pretty good source, and can be cited for criticism of the WHO report. I worked it in here (keeping in mind WP:WEIGHT issues; WHO is a much bigger fish than the several critics quoted, as Ernst notes in the source). regards, Middle 8 (talk) 04:04, 4 June 2009 (UTC)
If I might step in: The evidence for acupuncture is weak, and recent studies have made it weaker. It has been shown to be ineffective for some conditions, but may be effective for others, mainly related to pain or nausea, though the evidence has grown weaker over time. We can and should reflect this. However, without good sources, we can't just say what we want. Shoemaker's Holiday (talk) 02:23, 3 June 2009 (UTC)
Have "recent studies have made it weaker" according to a good source (preferably something on the order of a good review article)? And if it is true, why did the 2009 Cochrane review for nausea get stronger for efficacy than the previously-revised version? It's more accurate to say that recent studies have weakened the evidence base for some applications and strengthened it for others, as one of the sources in the lead does, coincidentally. regards, Middle 8 (talk) 04:37, 3 June 2009 (UTC)

I suggest this news article http://news.bbc.co.uk/2/hi/health/7011738.stm and others. Now, i had to basically throw out the interpretation that was made by some journalists. I think I'm being intellectually honest in saying that what this study actually shows is that Acupuncture is no more valid or effective than a drunken child randomly slamming nails into your back. Which luckily is mentioned in the BBC's interpretation of the story. The original study is to be found here: http://archinte.ama-assn.org/cgi/content/full/167/17/1892?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=acupuncture&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT Other news outlets reported on it saying that "Acupuncture works! Whether real of fake" (which is terribly deceitful) You do need a subscription to access the study, which is why I haven't read it yet. I am basing all I say on what was reported on the study by the press. Which, granted, isn't the best way to go about it. This news article and others should however be enough to state something like this: A German study on the effect of acupuncture on chronic low back pain didn't observe a distinction in the effects of classical acupuncture and a sham version that does not adhere to traditional rules. The study showed that there was a benefit in both of these procedures compared to no procedure at all, suggesting that the improvements are attributable to placebo- or non-specific effect. The last bit of this sounds like non-sceptics are going to jump all over it, I think it should be worded differently, it is none the less backed up by the reports and, presumably, by the study(?). What do you think? - the original poster —Preceding unsigned comment added by 88.130.73.178 (talk) 23:32, 10 June 2009 (UTC)

That well-known study is included in the corresponding reviews that are cited and discussed in the article. WP prefers citing reviews over single studies. regards, Middle 8 (talk) 04:47, 12 June 2009 (UTC)

Idea for resolution: How about replacing the beginning with: "Acupuncture is a pseudoscientific technique of inserting and manipulating fine filiform needles into specific points[...]" Presumably, consensus (?) on the inclusion of Acupuncture in the List of topics characterized as pseudo-science would make the inclusion of the term in the articles introduction non-controversial? —Preceding unsigned comment added by 88.130.125.232 (talk) 21:42, 19 June 2009 (UTC)

How does saying it's a pseudoscience right off the bat resolve anything? That just irritates more people more and is going to create more conflict. Can we get that post removed or does that take a consensus of someone trying to be non-helpful? Burleigh2 (talk) 18:05, 25 June 2009 (UTC)
@88.130.125.232: no, that wouldn't work. Please see WP:PSCI which explains when and how to use the term on WP. Then re-read the opening paragraphs at List of topics characterized as pseudoscience. Inclusion on that list does not necessarily indicate consensus among either scientists or Wikipedians that a topic is, in fact, pseudoscientific. regards, Middle 8 (talk) 04:04, 27 June 2009 (UTC)
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