Acupuncture in Emergency Departments

I have read in todays Sydney Morning Herald that Victorian Emergency Departments are going to trial acupuncture for the treatment of acute migraine, back pain and ankle injuries. Quoting the Herald, "The National Health and Medical Research Council has granted more than $400,000 for a three-year clinical trial in which 400 people will receive drug therapy, acupuncture or both to treat pain."
Apparently there has been a pilot study run at Northern Hospital in Epping, Victoria. This pilot study has allegedly shown promise with managing pain and nausea.
An Emergency Physician Robyn Parker said that patient who turned up at the Emergency Department were given the option of being treated by final year or graduate acupuncture students from RMIT in conjunction with standard medical treatment. Allegedly patients reported a significant reduction in pain and most said they would have it again.
In this multiple Emergency Department trial traditional Chinese medicine practitioners will be employed to carry out the acupuncture.
The lead researcher, Marc Cohen, a professor of complementary medicine at RMIT, said that the patients pain levels will be assessed every hour up until they leave Emergency and for several days afterwards to see which treatment worked best.
What worries me about these trials if carried out the way the pilot study was, is the unscientific way the trials are formulated. I am no scientist but surely a proper clinical trial is double blinded. The pilot study if going on reports in the SMH was not blinded at all. Any improvement in pain and nausea could be put down to the placebo effect. Pain and nausea are very subjective symptons so the placebo effect needs to be ruled out.
According to the authors of the book "Trick or Treatment", Simon Singh and Professor Edzard Ernst a Complementary Medicine Professor. The conditions where acupuncture has possibly shown some benefit in properly conducted trials are, pelvic and back pain during pregnancy, low back pain, headaches, post-operative nausea and vomiting, chemotherapy induced nausea and vomiting, neck disorders and bed wetting.
They do stress that essentially acupuncture seems to only have a placebo effect.
I think much caution should be placed on the findings of this trial once it is finished because as I see it, it will be done in a very unscientific way. I hope I am wrong and they will do randomised double blind studies.

UK Chiropractors in Crisis

You may have been aware of the recent libel case in the UK courts concerning the British Chiropractic Association and the British science writer Simon Singh. The preliminary hearing for the libel case brought against Simon Singh by the British Chiropractic Association was heard in early May.
Mr Justice Eady held:
1. that what Dr Singh had published was defamatory of the BCA in exactly the way the BCA had claimed; and
2. that Dr Singh’s allegations were not comment but were serious defamatory allegations of fact against the BCA.
Dr Singh’s application for permission to appeal to the Court of Appeal was refused by the Judge. Dr Singh has indicated, however, that he proposes to challenge that decision at the Court of Appeal and he now has three weeks to lodge that challenge.
Mr Justice Eady ordered Dr Singh to pay the BCA’s costs of the hearing within 28 days.
Since then there has been a great deal of interest in the sceptical, scientific community regarding this case.
A legal blogger "Jack of Kent" Has this on his blog.
This is the offical text of the ruling of the English High Court on the question of meaning at the preliminary hearing of British Chiropractic Association v Simon Singh on 7 May 2009.
The scientists are concerned because of the libel laws in Britain are so severe that any scientific challenge to a claim made by a person or organisation whether scientific or pseudoscientific can possibly be defamatory.
Dr, Singh has decided to appeal. He has this to say.
Since then many complaints have gone in about the claims made by Chiropractors in particularly their claim to "fix" childhood asthma, colic, whiplash.
Their is one big Chiropractic comglomerate McTimoney Chiropractors that have sent a "secret" email to all of their members. The secret letter is below.
So it seems that this ruling has come back to bite the British Chiropractors.
A secret letter to chiropractors.
Keep libel laws out of science
I will keep you all updated on this case as it progresses.