January 22, 2024

expert reaction to RCT of acupuncture for stroke patients with motor aphasia

A study published in JAMA Network Open looks at the effect of acupuncture on patients with post stroke motor aphasia. 

Prof Edzard Ernst, Emeritus Professor of Complementary Medicine, University of Exeter, said:

“Superficially, this looks like a rigorous trial. We should remember, however, that several groups, including mine, have shown that very nearly all Chinese acupuncture studies report positive results. This suggests that the reliability of these trials is less than encouraging. Moreover, the authors state that real acupuncture induced ‘de chi’, while sham acupuncture did not. This shows that the patients were not blinded and the outcomes might easily be due to a placebo response.”

Les Rose, Former Clinical Science Consultant, and Trustee of Health Science, said:

“The most obvious flaw in this study is that it was most likely not blinded. The authors state that “The De Qi sensation was induced during acupuncture stimulation”, and that “Acupuncture stimulation in SA induced no De Qi sensation”. Assuming that “de qi” is a real effect (and it may not be), the patients must have been aware of their treatment groups. The authors admit that they did not test blinding effectiveness. The practitioners obviously were not blinded, and they could have stimulated acupuncture points until the patient reported a sensation. They might not bother to do this for the sham treatment.

“It is not clear whether assessment of outcomes was done by blinded assessors, or whether the statistician was blinded. Overall, the paragraph on blinding is very brief.

“There are many reports in the literature about the unreliability of acupuncture studies conducted in China, eg: https://www.liebertpub.com/doi/abs/10.1089/acm.2014.5346.abstract?journalCode=acm.”

‘Effect of Acupuncture vs Sham Acupuncture on Patients With Poststroke Motor Aphasia’ by Boxuan Li et al. was published in JAMA Network Open at 16:00 UK time on Monday 22^nd January.

DOI: 10.1001/jamanetworkopen.2023.52580

Declared interests

Les Rose: I have no conflicts of interest to declare.

Prof Edzard Ernst: I have no conflicts of interest

For all other experts, no reply to our request for DOIs was received.