Several weeks ago, I wrote about the need for a new paradigm, one that integrates Eastern inductive and Western reductive methodology so that efficacy can truly be measured in alternative medicine trials. In that post, which was part of the DWIHC Comparative Effectiveness Research Series, I argued that Western researchers continue to try to squeeze a square peg into a round hole, and in doing so, ignore the subjective element that is an inherent part of the fabric that we call Eastern medicine.

This past week, I ran across a study in Menopause that not only supports this contention but also challenges us to more closely examine the limitations of current investigations into alternative therapies.

ACUFLASH (the Acupuncture on Hot Flashes among Menopausal Women Study) was a randomized, controlled, parallel study comparing the efficacy of weekly acupuncture plus self-care to self-care alone in 277 menopausal women experiencing, on average, 7 or more hot flashes daily. But here’s the rub: unlike previous trials, ACUFLASH actually estimated the effectiveness of acupuncture in practice, meaning that the study was specifically designed to mimic the basic tenets of Eastern philosophy and incorporate the subjective. Consequently, after agreeing upon expected diagnoses and recommended point selection, licensed Traditional Chinese Medicine acupuncturists were free to diagnose, select acupuncture points and individualize treatment for each study participant.

Not only did the mean frequency of hot flashes decline at least 50% in half of women receiving acupuncture plus self-care, but significant improvements were also noted in hot flash intensity and overall quality of life measures. More importantly, by incorporating a larger study group, and eliminating sham needles and “standardized” (compared to individualized) practice, the researchers were better able to preserve the overall quality of acupuncture and what it strives in achieve, while still remaining true to the tenets of evidence-based scientific methodological standards.

Is this study without flaws? Certainly not. Indeed, the investigators acknowledge that the study participants were not treatment naive, and point out that sham acupuncture, which may be necessary for a true comparative analysis, is hardly “physiologically inert.” Nevertheless, I remain hopeful that the study design and its positive results may open the alternative therapy door a bit wider and lend further credence to its role in treating disease.

Related posts:

1. Comparative Effectiveness Research: Thinking outside the box
2. Comparative Effectiveness Research Smack Down: June 22nd Kicks Off A Policy Challenge through the Eyes of Disruptive Women in Health Care
3. Adherence: Working Across Our Boundaries
4. Comparative effectiveness research: do we need to reevaluate research ills?

This entry was posted on Tuesday, July 14th, 2009 at 7:07 am and is filed under Alternative Medicine. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.