Sunday, August 15, 2010

New England Journal of Mendacity

Some loser doctors who pander to gullible rich people who Want to Believe have reviewed the evidence for acupuncture in the July 29th issue of the New England Journal of Medicine.

For those who don't subscribe to the NEJM, Steve Novella at Science Based Medicine has excerpts. Here's the paper's conclusion:
"As noted above, the most recent well powered clinical trials of acupuncture for chronic low back pain showed that sham acupuncture was as effective as real acupuncture. The simplest explanation of such findings is that the specific therapeutic effects of acupuncture, if present, are small, whereas its clinically relevant benefits are mostly attributable to contextual and psychosocial factors, such as patients’ beliefs and expectations, attention from the acupuncturist, and highly focused, spatially directed attention on the part of the patient."
And the author's recommendations for a hypothetical middle-aged male with chronic low back pain:
"He has specifically requested a referral for acupuncture, and we would suggest a course of 10 to 12 treatments over a period of 8 weeks from a licensed acupuncturist or a physician trained in medical acupuncture."
tl;dr: Acupuncture is crap. But tell your patients to go ahead and drop about a thousand bucks on it.

Someone commenting on Novella's article using the nick "urodovic" said this:
I e-mailed the NEJM editors and got a quick reply. Due to confidentiality issues I cannot post their exact response.

Briefly, they state that they are aware of the controversial aspect of the published article but that the ultimate judge once "the evidence" is presented, will be the reader.

OK now that just makes me rage.

Imagine if we were talking engineering or accounting rather than medicine. Someone says, "Hey the numbers in that article don't add up," and the journal editor says, "You, dear reader, can use your own math skills to calculate the correct answer."

Sorry, not good enough.

There's a right way and a wrong way to respond to valid criticism. The right way involves admitting the mistake, investigating why it happened, and making some effort to prevent it from happening again.

My email:

Dear NEJM editors,



The Tufted Titmouse

NEJM: Even the best can publish nonsense, by Mark Crislip.
Acupuncture Pseudoscience in the New England Journal of Medicine, by Steve Novella.
Credulity about acupuncture infiltrates the New England Journal of Medicine, by David Gorski.

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