Skepfeeds-The Best Skeptical blogs of the day

Important Studies


Welcome to my important studies page. In this page I will attempt to gather and keep updating any new studies that are related to skepticism under various categories and subcategories, such as Acupuncture, homeopathy, vaccines etc etc. The selection criteria for study inclusion are simple, they must be at the very least, blinded (double is preferable), they must be big enough (a study with 24 patients unfortunately is not big enough to tell us something either way), they must control for the placebo effect, basic stuff really. Systematic reviews, or meta-analyses will also be included, depending on how good I judge them to be. For these we can’t directly apply the above mentioned criteria, however we can apply them to the studies under review. If the studies under review are good and if we assume the statistics was applied properly, we can have a pretty high level of confidence on the conclusions of the authors.

Obviously there will be some bias, since I’ll be choosing the studies myself, but if anyone has any objections as to my choices, feel free to let me know in the comments.Please feel free to leave me links in the comments of relevant studies and suggestions for categories of importance. Alternatively you may send suggestions and links to my e-mail address at thoushallthink@gmail.com. Thank you and I hope this proves helpful.

UPDATE 01-07-2010 : I have decided that in addition to actual study texts, to start adding links to news items about studies that may not be available for free, or that I can’t find a direct link to. Unlike the actual studies, the links should be viewed with a bit less confidence as we are confined to what the reported choose to focus on.

Alternative Medicine

Chiropractice

A systematic review of systematic reviews of spinal manipulation, E. Ernst & P. H. Canter, Journal of the Royal Society of Medicine, Volume 99, April 2006. Pg 192-196

Collectively these data do not demonstrate that spinal manipulation is an effective intervention for any condition. Given the possibility of adverse effects, this review does not suggest that spinal manipulation is a recommendable treatment.

Acupuncture

Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups, Matias Vested Madsen, Peter C Gøtzsche and Asbjørn Hróbjartsson, British Medical Journal, Volume 338, 7 February 2009, BMJ 2009;338:a3115

Conclusions A small analgesic effect of acupuncture was found, which seems to lack clinical relevance and cannot be clearly distinguished from bias. Whether needling at acupuncture points, or at any site, reduces pain independently of the psychological impact of the treatment ritual is unclear.

The impact of acupuncture on in vitro fertilization outcome, Domar AD, Meshay I, Kelliher J, Alper M, Powers RD., PMID: 18314118 [PubMed - indexed for MEDLINE]

CONCLUSION(S): The use of acupuncture in patients undergoing IVF was not associated with an increase in PRs but they were more relaxed and more optimistic.

A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain,Cherkin DC, Sherman KJ, Avins AL, Erro JH, Ichikawa L, Barlow WE, Delaney K, Hawkes R, Hamilton L, Pressman A, Khalsa PS, Deyo RA,PMID: 19433697

CONCLUSIONS: Although acupuncture was found effective for chronic low back pain, tailoring needling sites to each patient and penetration of the skin appear to be unimportant in eliciting therapeutic benefits. These findings raise questions about acupuncture’s purported mechanisms of action. It remains unclear whether acupuncture or our simulated method of acupuncture provide physiologically important stimulation or represent placebo or nonspecific effects.

Skepdude comment: The author’s conclusion that “acupuncture was found effective” is a major misstatement of the facts. Clearly, from their very own conclusion, it appears it does not matter where the needles are stuck or if they are stuck at all, which is very much consistent with a placebo effect. This study clearly shows that acupuncture performed no better than placebo.

Analgesic effect of acupuncture needle penetration: a double-blind crossover study. Nobuari Takakura, Hiroyoshi Yajima,Open Medicine, Vol 3, No 2 (2009)

Interpretation: Needle penetration did not confer a specific analgesic advantage over non-penetrating (placebo) needle application.

Vaccines

A POPULATION-BASED STUDY OF MEASLES, MUMPS, AND RUBELLA VACCINATION AND AUTISM, – AKA DANISH AUTISM STUDY, KREESTEN MELDGAARD MADSEN , M.D., ANDERS HVIID, M.S C., MOGENS VESTERGAARD , M.D., DIANA SCHENDEL, PH.D, The New England Journal of Medicine, Volume 347, Number 19, November 7, 2002, Pages 1477-1482.

There was no association between the age at the time of vaccination, the time since vaccination, or the date of vaccination and the development of autistic disorder. Conclusions This study provides strong evidence against the hypothesis that MMR vaccination causes autism.

Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study, Mady Hornig, Thomas Briese, Timothy Buie, Margaret L. Bauman, Gregory Lauwers, Ulrike Siemetzki, Kimberly Hummel, Paul A. Rota, William J. Bellini, John J. O’Leary, Orla Sheils, Errol Alden, Larry Pickering, W. Ian Lipkin, PLoS ONE, , Volume 3, Issue 9, September 2008

This study provides strong evidence against association of autism with persistent MV RNA in the GI tract or MMR exposure. Autism with GI disturbances is associated with elevated rates of regression in language or other skills and may represent an endophenotype distinct from other ASD.

ARTICLE - Another study finds no MMR-autism link

Homeopathy

Effect of homeopathy on analgesic intake following knee ligament reconstruction: a phase III monocentre randomized placebo controlled study, British Journal of Clinical Pharmacology, Volume 65, Issue 2, Pages 180-187, August 9, 2007.

The homeopathic treatment tested in this study was no better than placebo for postoperative pain management after knee ligament construction.Furthermore, this treatment seemed to have no placebo effect in these conditions. However, inclusion in a trial that evaluates homeopathy leads to an improvement in the patient’s opinion about the treatment irrespective of the results.

Homeopathy for Childhood and Adolescence Ailments: Systematic Review of Randomized Clinical Trials, Mayo Clin Proc., January 2007;82(1):69-75

CONCLUSION: The evidence from rigorous clinical trials of any type of therapeutic or preventive intervention testing homeopathy for childhood and adolescence ailments is not convincing enough for recommendations in any condition.

Other/Multiple CAM Modalities

ARIA update: I—Systematic review of complementary and alternative medicine for rhinitis and asthma, Journal of Allergy and Clinical Immunology, 2006 May, v 117(5), pp 1054-62

CAM is widely practiced, and many patients who use it appear to be satisfied. From a scientific viewpoint, there is no definitive or convincing proof of efficacy for most CAMs in rhinitis or asthma. In general, the methods used to study them are often inadequate (ie, not randomized, not controlled, and not blinded, with no quantitative measurement). 94 Considering the randomized controlled trials, there is no clear evidence for the efficacy of acupuncture in rhinitis and asthma. Some positive results were described in rhinitis with homeopathy in good-quality trials, but an equal number of negative studies counterbalance the positive ones. Therefore it is not possible to provide evidence-based recommendations for the use of homeopathy to treat allergic rhinitis, and further randomized controlled trials are needed. Some herbal remedies have proved effective in rhinitis or asthma, but the studies are
too few to make recommendations, and there are safety and drug interaction concerns. In fact, herbal remedies are usually not sufficiently standardized and can also contain harmful substances,95,96 such as the ephedrinecontaining remedies that have been banned in the United States.

………………………………………………

Some physical techniques (eg, yoga breathing or breath retraining) can provide an additional benefit in terms of perceived well-being, but they cannot be recommended as effective treatments for asthma.
The therapeutic efficacy of CAM treatments is not supported by currently available evidence. More data from randomized DBPC trials are required. In addition, CAMs might not be devoid of side effects, and some of them might interact with other medications.

Herbs and stuff

Ginkgo biloba for Preventing Cognitive Decline in Older Adults: A Randomized Trial, Beth E. Snitz; Ellen S. O’Meara; Michelle C. Carlson; et al, The Journal of the American Medical Association, 2009;302(24):2663-2670.

Objective To determine whether G biloba slows the rates of global or domain specific cognitive decline in older adults.

Design, Setting, and Participants The Ginkgo Evaluation of Memory (GEM) study, a randomized, double-blind, placebo-controlled clinical trial of 3069 communitydwelling participants aged 72 to 96 years, conducted in 6 academic medical centers in the United States between 2000 and 2008, with a median follow-up of 6.1 years.

Intervention Twice-daily dose of 120-mg extract of G biloba (n=1545) or identical appearing placebo (n=1524).

Conclusion Compared with placebo, the use of G biloba, 120 mg twice daily, did not result in less cognitive decline in older adults with normal cognition or with mild cognitive impairment.


3 Responses

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  1. [...] Important Studies [...]

  2. [...] sham acupuncture which doesn’t even penetrate the skin! Check out my Acupuncture section on my Important Studies page. Not all inclusive by any means, but quite [...]

  3. [...] could not have helped you with your back problems (check out a few studies I link to in my Important Studies page). Why is it that all these alt med modalities can’t seem to help with anything that can [...]


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