Evidence-based acupuncture

E. Ernst – M.D., Ph.D.
United Kingdom

In spite of its long history, the efficacy of acupuncture for several indications has not. been demonstrated beyond reasonable doubt. The “gold standard” methodology to test for efficacy of any therapy is the randomized clinical trial (ROT). Acupuncture is no exception. It is, of course, difficult to perform placebo (sham)-controlled or double-blind trials, but randomization, a method to minimise selection bias, is no true obstacle for acupuncture research.

Unfortunately, one RCT is rarely sufficient for drawing firm conclusions. Independent replications are essential. Where several trials for one condition exist, they rarely have precisely the same result. Therefore, it is important to evaluate the totality of all trials on one given topic.

The best way of achieving this is to perform a systematic review. This type of evaluative approach can be viewed as the backbone of evidence-based medicine. It should also be applied to acupuncture.

Employing this approach, acupuncture can be shown to be effective for dental pain, back pain and nausea/vomiting. For smoking cessation and weight loss, the data are negative and for all other conditions the evidence for or against acupuncture is so far inconclusive.

Applying the principles of evidence-based medicine to acupuncture provides a chance to prove or disprove its efficacy to the standards, which today are demanded of any treatment.