Skepfeeds-The Best Skeptical blogs of the day

Repeat after me: Acupuncture does not do anything for hot flashes!

Posted in Skepdude by Skepdude on May 19, 2009

Why is it that every few months there has to be yet another worthless, badly designed study to make a ruckus about acupuncture and hot flashes? Or hypnosis and hot flashes? What is it about hot flashes that has people so intrigued? I have had entries in the past about hot flashes and alternative medicine (here, here and here are some examples). A new study has been published, yet again making the claim tha acupuncture works well to reduce hot flashes in menopausal women. Here we go again!

Objective: This study compared the effectiveness of individualized acupuncture plus self-care versus self-care alone on hot flashes and health-related quality of life in postmenopausal women.

Red Flag There was no control group! Giving one groups acupuncture and the other nothing does not constitute a control group. The control groups should have gotten fake acupuncture and self-care in order to be effective. The authors have no way of controlling for the placebo effect. The comparison between the two groups is rendered meaningles.

Methods: This study involved a multicenter, pragmatic, randomized, controlled trial with two parallel arms. Participants were postmenopausal women experiencing, on average, seven or more hot flashes per 24 hours during seven consecutive days. The acupuncture group received 10 acupuncture treatment sessions and advice on self-care, and the control group received advice on self-care only. The frequency and severity (0-10 scale) of hot flashes were registered in a diary. Urine excretion of calcitonin gene-related peptide was assessed at baseline and after 12 weeks. The primary endpoint was change in mean hot flash frequency from baseline to 12 weeks. The secondary endpoint was change in health-related quality of life measured by the Women’s Health Questionnaire.

Results: Hot flash frequency decreased by 5.8 per 24 hours in the acupuncture group (n = 134) and 3.7 per 24 hours in the control group (n = 133), a difference of 2.1 (P < 0.001). Hot flash intensity decreased by 3.2 units in the acupuncture group and 1.8 units in the control group, a difference of 1.4 (P < 0.001). The acupuncture group experienced statistically significant improvements in the vasomotor, sleep, and somatic symptoms dimensions of the Women’s Health Questionnaire compared with the control group. Urine calcitonin gene-related peptide excretion remained unchanged from baseline to week 12.

Conclusions: Acupuncture plus self-care can contribute to a clinically relevant reduction in hot flashes and increased health-related quality of life in postmenopausal women.

StopCareful wording, but insufficient to say the least. At the very least the authors should have mentioned that the way their study was designed, it was impossible for them to separate the placebo effect from any real effects due to accupuncture. It is such a glaring omission that it makes you wonder how it could have been missed? Do you want to bet the the sCAM crowd will jump all over this study, proclaming that yet another study shows acupuncture’s efficacy?  I give the authors a D for effort and an F for their science.


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