Dan C. Cherkin, PhD; Karen J. Sherman, PhD, MPH
Potential Financial Conflicts of Interest: None disclosed.
Cherkin DC, Sherman KJ. Acupuncture and Knee Osteoarthritis. Ann Intern Med. 2005;142:872. doi: 10.7326/0003-4819-142-10-200505170-00019
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Published: Ann Intern Med. 2005;142(10):872.
TO THE EDITOR:
Berman and colleagues' recent trial evaluating acupuncture for osteoarthritis of the knee (1) is one of the most scientifically rigorous acupuncture trials ever conducted. Noteworthy strengths include a sham acupuncture treatment that closely mimicked real acupuncture, a minimal-intervention control group, large sample sizes, a clinically credible acupuncture treatment, acupuncture-naive participants, short-term and longer-term outcome measures, multiple sites and acupuncturists, balanced allocation of true and sham treatments for each acupuncturist, and high rates of adherence.
The study's most obvious limitation is the high rate of loss to follow-up in the education group. If those failing to provide follow-up data benefited least from this intervention (as seems likely), education's effectiveness would be overestimated, and therefore the relative benefits of acupuncture would be underestimated. Of greater relevance to the primary findings is that participants receiving true acupuncture were more likely than those receiving sham acupuncture to believe they were receiving true acupuncture. Such findings could result either from specific benefits of needling Traditional Chinese Medicine (TCM) meridians or from use of an incompletely convincing sham treatment.
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