Does Acupuncture Work?

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I did not ask for meta-analyses - rather I said that a systematic review of the literature is necessary to know what the evidence says. A meta-analysis is not a systematic review, and generally suffers from the "garbage in - garbage out" problem.

A NEJM study showed that meta-analyses were very poor predictor of later large definitive clinical trials. Meta-anslyses do not solve the problem of poor trial design with acupuncture.

Further - even these meta-analyses could not be used to support acupuncture. Why didn't you quote the whole conclusion of the 2008 meta-analysis of depression:

"Both acupuncture and medication possibly are effective for depression with good safety. However, because of lower methodological quality of the trials, this conclusion needs further be confirmed."

Lower methodological quality - that is the problem with all the alleged evidence for acupuncture.  The best controlled trials remain negative.

I am simply advocating that the same standards of evidence are used for all medical questions. If a pharmaceutical company tried to use the quality of evidence you a citing for acupuncture to get approval for a drug, they would be harshly criticized, and rightly so.

Like everyone, I want to know if acupuncture actually works. The evidence, when objectively and thoroughly evaluated, simply says no.

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According to a paper written about randomization in clinical trials, the authors' state "RCTs are considered the most reliable form of scientific evidence in healthcare because they eliminate spurious causality and bias."

Most healthcare professionals would agree that RCTs are the "gold standard" for medical studies.  But when I cited several well performed RCTs, you replied that single RCTs are meaningless to prove the effectiveness of acupuncture.

I agree with you on the "garbage in - garbage out" statement on meta-analyses, and you pointed out that one of my meta-analyses concluded that the original RCTs had methodological weaknesses and that will be reflected in the results, but you can't make the  argument that acupuncture does NOT work, when the meta-analyses say absolutely with good P-values.

If you stood by my side at my clinic and heard my patient exclaim that she hasn't had a period in over a year, and after three weeks of treatment, she's had her first period or my patient that had her second sonogram to show that ALL of her uterine fibroids had vanished after 10 weeks of treatment, you can say she obviously "placebo'd" those fibroids away.  When a 16 year old with violent eczema comes in with her parents and shows her improvement compared to the pictures I took from the first visit, it must have been the light music and kind words I used during her treatment to have that effect.

I work with triathletes and their focus is on getting back to training.  If what I do for them doesn't get them back on their bikes or on the running trails, they'd drop me as part of their treatment regime in a heartbeat.

But what I do DOES work, and it works consistently.  Like it or not, the paradigm of "Drugs and Surgery" is fading in the American healthcare landscape.

Your statement about only 6% of Americans have ever had acupuncture doesn't hold water:  Let's do the math - There are 20,000 practicing acupuncturists in this country.  If we see (I'm lowballing this for those acupuncturists who don't work full time or are in their first year of practice, etc.) a total of 6 patients per day, 5 days per week, it comes to 31,200,000 treatments per year.  My PVA (patient visit average) is 8.3 this past year, which means a typical patient entering my clinic received an average of 8.3 treatments.  Assuming this stat across the country, a total number of patients treated this past year would be 3.76 Million.  We currently have a total population of 303,824,640 with 79.9% over the age of 14 years old, so 242,755,887 would be more likely to receive acupuncture treatment representing 1.5% of the population this year alone and the figure would double if I used realistic patient visits per day.  If we extrapolate out to over 35 years Oriental Medicine has been in this country (and yes, it grew over time to approximately 50 schools of Traditional Chinese Medicine), it shows that 6% is quite a small guess.