"Acupuncture shows promise for hot flashes"

[T'ai Chi]

Here is an interesting article on a exploratory study on acupuncture and hot flashes.

What do people think of the study design?

[CFLarsen]

What do you think?

[T'ai Chi]

It is nice that rational, skeptical, trained scientists are studying this stuff.

[casebro]

"The sleep improvements were seen in both groups, and acupuncture itself did not seem to have a special effect on sleep. However, Manber pointed out, the acupuncture points used in the study were chosen because they target hot flash symptoms, according to traditional* medicine."

I don't see any challenge winner here.

No numbers listed in the CNN article- acupunctuation may be lots better (doubt it) or barely better. Or, since menopause hot flashs do subside, how did they divide the subjects into two groups? Those recieving concomittant HRT get needles? Or by existinig length of menopause? Those who were estimated to be due to subside, real needles? Once again, we have a placebo treatment that relieves subjective items... at least as well as the placebo!

Just what "traditional" medicine did the Dr mean? Traditional pseudo-Sino-mystic traditions?

[Jeff Corey]

There is not enough detail to evaluate the design. What journal published this?

[CriticalThanking]

Originally Posted by Jeff Corey

There is not enough detail to evaluate the design. What journal published this?

From Tai's link: "...the journal Fertility & Sterility". From their website:

Official publication of the:

American Society for Reproductive Medicine
The Society of Reproductive Endocrinology and Infertility
Society of Reproductive Surgeons
Society for Assisted Reproductive Technology
Society for Male Reproduction and Urology
Pacific Coast Reproductive Society
Canadian Fertility and Andrology Society


Editor:
Alan H. DeCherney, M.D.

Associate Editors:
Edward E. Wallach, M.D.
Paul G. McDonough, M.D.

Fertility and Sterility, known as "the red journal," has world-wide circulation and is highly regarded in the United States and abroad. Now in its sixth decade, Fertility and Sterility publishes juried original articles of scientific excellence in clinical and laboratory research relevant to reproductive endocrinology, physiology, immunology, genetics and menopause. Citation analysis indicates that it is among the most frequently referenced scientific journals and has the highest immediacy and impact factors in the field of reproductive medicine. The journal is an indispensable resource to reproductive endocrinologists, obstetricians, gynecologists, urologists, and basic scientists who treat and investigate the problems of fertility, sterility and the physiology of reproduction.

CT

[casebro]

Is that the journal that stepped on it's dingbat with the prayer vs fertility, er somethin? some Korean scientist creating cold fertlility in the lab? acupunctuation treatments for mulitple fallopian tubes? C'mon, help me out here....

[Goshawk]

Twenty-nine women is a very tiny, not statistically useful study group.

[CFLarsen]

Originally Posted by T'ai Chi

It is nice that rational, skeptical, trained scientists are studying this stuff.

What do you think of the study design?

[Deetee]

I have not been able to see the original paper as yet - is it available on line anywhere?
From here. Emphasis mine.

Quote:

For their study, she and her colleagues randomly assigned 29 women to receive seven weeks of acupuncture or a “sham” version of the procedure. In the latter case, acupuncturists used flat-tipped needles that did not pierce the skin, placing them on areas of the skin not considered to be acupuncture points. The patients could not see that the needles weren’t piercing their skin.
By the end of treatment, women who’d been getting the real acupuncture sessions reported a greater reduction in the severity of their nighttime hot flashes than those in the comparison group.
Both groups said their hot flashes had become less frequent, the researchers found, and as hot flash symptoms improved, so did the women’s sleep quality.
The sleep improvements were seen in both groups, and acupuncture itself did not seem to have a special effect on sleep. However, Manber pointed out, the acupuncture points used in the study were chosen because they target hot flash symptoms, according to traditional medicine. So the therapy was not designed to directly address sleep problems, she said.

From here.

Quote:

The results showed that nighttime hot flash severity decreased significantly (28%) among the women who received acupuncture vs. a 6% drop among the women who got the sham treatment. However, they did not see a similar finding in the frequency of nighttime hot flashes between the two groups.

One really needs to see the trial design in detail, but it seems above board with appropriate placebo-controls. Small study sample - presumably 14 in one group and 15 in the other? With these small numbers, would a qualitative, non-dichotomous outcome such as a severity score reach appropriate statistical significance?
Also it is impossible to say what other factors may have influenced the outcomes without knowing more about the study.

ETA the CNN report states

Quote:

In a study of 29 women with frequent, daily hot flashes, researchers found that those who received acupuncture began to have fewer and less severe symptoms during the night.

This is a misrepresentation of the study, even as they actually report it. There was an equivalent reduction in frequency for those on sham acupuncture, so CNN's comment is misleading in that it attributes both reduction in severity AND frequency to acupuncture.

[Zep]

Originally Posted by CriticalThanking

From Tai's link: "...the journal Fertility & Sterility". From their website:

Official publication of the:

American Society for Reproductive Medicine
The Society of Reproductive Endocrinology and Infertility
Society of Reproductive Surgeons
Society for Assisted Reproductive Technology
Society for Male Reproduction and Urology
Pacific Coast Reproductive Society
Canadian Fertility and Andrology Society


Editor:
Alan H. DeCherney, M.D.

Associate Editors:
Edward E. Wallach, M.D.
Paul G. McDonough, M.D.

Fertility and Sterility, known as "the red journal," has world-wide circulation and is highly regarded in the United States and abroad. Now in its sixth decade, Fertility and Sterility publishes juried original articles of scientific excellence in clinical and laboratory research relevant to reproductive endocrinology, physiology, immunology, genetics and menopause. Citation analysis indicates that it is among the most frequently referenced scientific journals and has the highest immediacy and impact factors in the field of reproductive medicine. The journal is an indispensable resource to reproductive endocrinologists, obstetricians, gynecologists, urologists, and basic scientists who treat and investigate the problems of fertility, sterility and the physiology of reproduction.

CT

This name rings some bells that DO chime in my head (tks, pillory), w.r.t. proponents of woo theories. Anyone care to provide more detail?

[CFLarsen]

Originally Posted by Zep

Anyone care to provide more detail?

Isn't that T'ai's job?

[Asolepius]

Originally Posted by T'ai Chi

Here is an interesting article on a exploratory study on acupuncture and hot flashes.

What do people think of the study design?

I am puzzled by the `placebo'. Why did they choose to place fake needles on fake acupuncture points? We now can't separate the effect of needling from the importance of the points used. I have not seen this done before - normally one does one or the other.

Otherwise I can't really comment without seeing the full text paper. It does look like a rather small study, and the newspaper is quite circumspect about the conclusions - rightly so.