Learning to look at research

Another study on the use of acupuncture was recently in the news. My source story came from Reuters, titled “Acupuncture Needling Doesn’t Ease Menopausal Hot Flashes“, which not so surprisingly is following previous studies showing benefits.

The study used a nice large-ish sample size: 327 Australian women, and offered them 10 treatments over 8 weeks of either an acupuncture protocol for a “kidney yin deficiency” diagnosis or a “sham” protocol, described as being without needle insertion. The results found similar responses of reductions in hot flash occurrences by about 40% as well as similar impacts on quality of life factors. The lead researcher is a family physician “trained” in acupuncture. How much training? My source didn’t elaborate — did she do the full multiple-year study program, or a shortened course for physicians?

On the face of it, this seems like a reasonable sort of study,. The problems that I see with it are as follows:

  1. “menopause” as defined in Western medicine does NOT precisely match up to a single East Asian traditional medicine diagnosis. Historically, the kidney yin diagnosis actually originated in an attempt to modernize traditional Chinese medicine (as explained by the erudite Volker Scheid in  Not Very Traditional, nor Exactly Chinese, So What Kind of Medicine Is It? TCM’s Discourse on Menopause and Its Implications for Practice, Teaching, and Research), which — at least for me — calls into question its validity as a useful diagnosis.
  2. However, even if I weren’t being so snobby about potential diagnoses, this sort of study ignores a KEY aspect of the East Asian traditional medicine diagnostic process, which is BY pattern, not just a symptom like hot flashes. The flexibility of the medicine is its strength (just like bamboo) and a better study would be based on this individualized diagnosis and therapeutic choices.

Studies like this make me realize that I want to learn more about READING and understanding studies, as well as being part of creating  them, like in a residency program!

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