NY Times IMESHINDWA – Acupuncture

Today I found hii article in NY times health – touting the benefits of acupuncture used for depression relief in pregnant women. I have a few problems with the journalist, Shirley S. Wang, failing to remain skeptical in her piece. But this comes as no surprise, so I won’t bother to point out obvious flaws in the media.

I will point out the flaws in the study. Please find the original full text, hapa. So after reading this paper I have come to a few conclusions.

1) Very small sample size of 150 patients, only 141 treated.

2) The study is blinded ONLY for the depression scoring, not administration of acupuncture. Kwa kweli, their release form states “Participants in one of these two groups will receive acupuncture that focuses on depression symptoms and the other treatment will not.” Makes sense, getting a needle shoved in your skin is easy to notice. Hivyo, these “randomized and blinded” participants knew what was coming and assumed that any poking was supposed to help their depression. Zaidi ya hayo, hii (much better) study has shown that simulated acupuncture with toothpicks works just the same. Careful, this is compelling evidence against the validity of acupuncture – not evidence for the usefulness of stimulated “pressure points”. It is a placebo effect.

3) Study assumes validity of “depression specific” na “non-specific” acupuncture. Meaning one method of pin sticking somehow cures depression over another. What is this based on? Oh Ngoja, they say exactly the exhaustive scientific evidence right here: “patterns of disharmony according to the principles of traditional Chinese medicine”. I’m sorry, tafadhali, give me modern medicine over 2,000 year old mythical beliefs. How was the average quality of life and life expectancy for an ancient chinese person? Pretty damn horrible, and I’m sure the average life expectancy did not exceed 35 miaka.

4) Basing depression scores on one administration of the DSM-IV Hamilton Rating Scale. Not being a psychiatrist I can’t speak to the efficacy of these tests. Lakini, I will go out on a limb and assume that a stronger baseline for depression should be established before comparing results. The test may be accurate, but why not administer it more than once to reduce noise.

5) Selection of massage as a second control. This is a bad attempt at token skepticism, hata wanasema moja kwa moja “Massage ilizingatiwa kama matibabu ya udhibiti kwa sababu, ingawa inaboresha hisia mara baada ya kikao, hakuna ushahidi wa kutosha kuunga mkono ufanisi wake kama matibabu ya unyogovu.” Ninapobuni utafiti napenda kuangalia mambo yote yanayojulikana ambayo ninaamini yatapinga dhana yangu. Kuchagua kitu ambacho tayari unaamini kitashindwa kunaonyesha tu mkono wao wa upendeleo mkubwa.

6) Kushindwa kudhibiti mambo ya kijamii na kiuchumi. 67% wa washiriki walikuwa wazungu, wengi wao walikuwa na elimu ya kutosha. Wanaenda hata kueleza kwenye mjadala “Kwa hiyo, Huenda matokeo yasisawazishe kwa vikundi maalum vya wachache ambavyo vilikuwa na uwakilishi mdogo katika sampuli yetu”. Je, ni mimi tu, au kauli hii inakanusha ukamilifu wa utafiti wao? They are freely admitting that acupuncture might not work as well in other minority groups. Why could this be? The only logical and scientific answer is that a placebo effect differs across socioeconomic boundaries. If, baada ya yote, acupuncture was a legitimate medical science, there would be an insignificant difference seen across physiologically identical organisms.

This study is appallingly bad science. These researchers are beginning with the premise that acupuncture works, and searching for data to support their claims. This is exactly opposite of how to conduct real science. Na, our health reporter at the NY Times didn’t even bat an eye. Fail for you Mrs. Wang, and fail to the NY Times.