This course will discuss the Effectiveness, efficacy, mechanisms, problems and solutions in acupuncture research. It will delve into the following:
- Does acupuncture work?
- How does acupuncture work?
- Problems and solutions in acupuncture research
Does acupuncture work?
A review of the current status of effectiveness/efficacy research]
Quantity and rapid growth of clinical trials
The Acupuncture Evidence Project
Acupuncture for chronic and acute pain (research summary)
How does acupuncture work?
- Acupuncture analgesia research– neural transmission pathways, opioid and non-opioid mediators, mesolimbic loop of acupuncture analgesia, lasting modulation and neuroplasticity
- Anti-inflammatory effects of acupuncture– HPA axis and inflammatory oedema (edema); specific mediators modulated by acupuncture in allergic rhinitis, IBS, ulcerative colitis, migraine, osteoarthritis and asthma; mediators, receptors and signalling pathways in allergic rhinitis, thermal hyperalgesia and allodynia; the central role of TRPV1 in allergic rhinitis and how acupuncture modulates it; the role of neurotrophins
- Acupuncture and chronobiology – the central role of the circadian clock and the suprachiasmatic nucleus (SCN) in physiology; acupuncture directly modulates genes and proteins in the SCN in insomnia; Yang sheng is essentially about regulating the circadian clock; screen-time must be managed; acupuncture is a zeitgeber (a factor which resets the body clock)
Problems and solutions in acupuncture research:
The paradox in acupuncture research: 3 possible explanations
Placebo effect: Current research; problems with measuring effect size and prevalence
5 types of sham acupuncture protocols; problems with placebo/sham acupuncture needle devices; sham acupuncture is not inert
Differences between real and sham acupuncture effects
Why are placebo-controlled studies used?
RCTs are inappropriate for complex interventions, including surgery and psychiatry
Failing to achieve maximum therapeutic benefit: effect of frequency & duration of treatments and practitioner training/skill level
Future directions in acupuncture research
Development pathways for clinical practice guidelines
Comparative trials and the Bayesian network meta-analysis – advantages and challenges.
Goals and Objectives
- To briefly review the current status of acupuncture effectiveness/efficacy research.
- To briefly review the current state of acupuncture mechanism research and explore the ways mechanism research can be used in communicating with other health professionals and patients.
- To understand why placebo-controlled randomised controlled trials consistently underestimate the effectiveness of acupuncture.
- To understand why randomised controlled trials are inappropriate for measuring effectiveness for complex interventions using examples from acupuncture, psychotherapy and surgery research.
- To explore the advantages and disadvantages of comparative trials and Bayesian network meta-analysis to inform clinical practice guideline development.
Dr John McDonald, PhD commenced acupuncture studies in Australia in 1971, clinical practice in 1975 and teaching acupuncture in 1977. In 1975 John blended his previous training as a psychiatric nurse with acupuncture to establish an acupuncture detoxification programme at the New South Wales Health Commission’s Narcotics Dependency Programme in Sydney. John has been a pioneer in developing acupuncture education in Australia in curriculum development and as a Dean, Department Head, senior lecturer and course coordinator in a number of colleges and universities. John was the inaugural President of the Australian Council for Chinese Medicine Education. In 2006 John participated in the finalising of the World Health Organisation Western Pacific Region Standard for Acupuncture Point Locations. Among John’s publications are the textbook “Zang Fu Syndromes: Differential Diagnosis and Treatment” co-authored with Dr Joel Penner from Los Angeles, seven peer-reviewed journal papers, 19 other journal papers, more than 30 health magazine articles and four videos. Recently John has, with Stephen Janz, co-authored a comparative literature review, The Acupuncture Evidence Project, sponsored and published by the Australian Acupuncture and Chinese Medicine Association of Australia Ltd (AACMA).
Currently John is an Adjunct Senior-Lecturer in the School of Medicine at Griffith University (where he conducted his PhD research into the immunological mechanisms underpinning the effects of acupuncture in allergic rhinitis). John is also Vice-President for Research of the Acupuncture Now Foundation, a lecturer and member of the Curriculum Advisory Committee at the Endeavour College of Natural Health and a reviewer for various peer-reviewed journals including Nature, BMJ, Evidence-Based Complementary and Alternative Medicine and Journal of Acupuncture and Meridian Studies. John has also recently been appointed to the Editorial Board of Digital Chinese Medicine at Hunan University of Chinese Medicine.