Which Works Better: Pretend Acupuncture or Sugar Pills?
By Krista on Apr 16, 2006 in Pain
Here's an interesting study linking the act of participating in a ritual with how effective treatment is.
Medical researcher Ted Kaptchuk wanted to see if it was possible to manipulate the placebo effect, so in a study sponsored by teh National Institutes of Health, he recruited 266 volunteers suffering from chronic arm pain which they rated at least a 3 on a 10-point scale.
Then he prescribed two types of fake medicines. 133 subjects received pretend acupuncture - the needles had retractable tips so they never penetrated the skin. The other 133 subjects were given a blue cornstarch pill.
25 percent of the acupuncture group experienced side effects from the nonexistent needle pricks, including 19 people who felt pain and 4 whose skin became red or swollen. 31 percent of the pill group experienced side effects from the make-believe drug, including dizziness, restlessness, rashes, headaches, nausea, and 4 cases of nightmares. Dry mouth and fatigue were the most common side effects, and 3 subjects withdrew from the study after reducing the dosage failed to control their symptoms. The reported side effects exactly matched those described by the doctors at the beginning of the study.
After 10 weeks, subjects taking sham pills said their pain decreased an average of 1.50 points on the 10-point scale. After 8 weeks, those receiving fake acupuncture reported a drop of 2.64 points. In other words, not receiving acupuncture reduces pain more than not taking drugs.
Kaptchuk chalks the results up to the ritual - acupuncture is more elaborate so patients think it works better.
Steven J. Steinberg | Apr 27, 2007 | Reply
Yes, BUT:
1. What type of starch was used in the placebo-pills? Might some of the test-subjects have had a sensitivity or allergy to that type of starch? Were the subjects pre-examined for such possibilities, and if not, why not?
2. What were the chemical components of the placebo-pills’ shell, including the coloring? Might some of the test-subjects have had a sensitivity or allergy to that those components? Were the subjects pre-examined for such possibilities, and if not, why not?
3. What other components, if any, were in those placebo-pills? Might some of the test-subjects have had a sensitivity or allergy to those components? Were the subjects pre-examined for such possibilities, and if not, why not?
4. As to the fake acupuncture: Especially considering that the subjects all reported arm-pain, were any of the subjects pre-examined as to — or were they pre-asked about — whether — their arms (or any area on their arms) were particularly sensitive to, and reactive to, pressure or pricking or scratching or being in ay way irritated? Id these subjects were not pre-tested, pre-examined, or pre-asked about these possible factors, why weren’t they?
5. If no such pre-investigations or quesries were done as outlined in my above questions, what does that suggest about the validity of the study or of the conclusions reached by the study’s authors?
6. As to the purely psychological component of the study: What, in each case, was the attitude of the doctor (and/or nurse, etc.) as presented to the subjects, before, during, and after the study? Was this carefully and objectively observed and duly documented? If not, what does that lack of relevant information suggest about the subjects’ physiological & psychological response and, therefore, the validity of the study?
7. Further, as to the purely psychological component of the study: What, in each case, was the attitude of the subjects, as to their own condition, and as to the medical profession, and as to the doctors/nurses (etcetera) in the study — and as to the environment in which the study took place — and as to the study itself, before, during, and after the study? Were they examined for, and asked about, their level of fear, worry, hopefulness, and trust (etcetera) of the medical profession and personnel and the study itself, bire, during, and after the study? Was any of this documented — and if not, why not? And if none of these factors, as above, was explored and documented, then what does that say about the validity of the study and the interetation of the study’s results?
Personally, while I’m not a doctor, I rail against “studies” that purport to be scientific and irrefutable but which, in fact, skip basic steps required by rigorous scientific research and thus are used to generate conclusions — interpretations — which, while appearing to the unquestioning mind to be accurate, are, in reality, flawed.
I would hope that this current “acupuncture vs placebo pills” research addressed these issues — but did it?
Krista | Apr 28, 2007 | Reply
If you are that interested in the study, I suggest you read the full text, which is available online. You can also view others’ responses to the study + the author’s comments on those responses.
It was published in the British Medical Journal, which is very well respected, peer reviewed journal so I wouldn’t say it “skip[ed] basic steps required by rigorous scientific research.”
Furthermore, I don’t know any scientist that would claim their study to be “irrefutable” - that’s more “faith” rather than science, which is about testing hypotheses, broadening the pool of current research, and adjusting theories according to research observations.