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Commentary on: Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture Trialists’ Collaboration. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med 2012;172:1444–53.
Acupuncture is controversial. Even if one assumes its overall effectiveness, common explanations for its causal impact are biologically implausible. Hence acupuncture is often dismissed as ‘no more than a placebo’, and this allegation is difficult to disprove as placebo-controlled trials are problematic. ‘Placebo’ needles stimulate sensory nerves and are possibly a less active treatment, ‘sham’ rather than ‘placebo’.1 Small differences between treatments require large sample sizes, as achieved by meta-analysis. Previous meta-analyses concentrated on finding all trials, but poor quality limited the conclusions.
This is a systematic review of randomised controlled trials (RCTs) of chronic headache and musculoskeletal conditions that had unambiguous allocation concealment and were assessed for risk of bias from blinding. The authors …
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