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In this Issue

In this Issue Highlights doi:10.1136/acupmed-2014-010523 Adrian White, Editor Expectancy must surely influence And anyway, the evidence varies on shows that acupuncture is superior the response to virtually every whether expectancy does truly to drug prophylaxis, not sham acu- medical treatment for virtually affect the clinical response, and puncture, for safety and effective- every condition—except perhaps a some studies find no effect. This ness for migraine. drug given while the patient is might be due to the context but Expectancy is ‘trending’ in clinical unconscious. And yet the topic of more likely is due to lack of tools acupuncture; neuroprotection is expectancy generates attitude, par- to measure it reliably. Sherman is ‘trending’ in acupuncture mechan- ticularly in acupuncture. involved in a detailed, theoretically isms. Acupuncture is used for deaf- At one end of the scale, some driven development of a new scale ness and tinnitus in the East though people dismiss acupuncture as ‘only for expectancy. Meanwhile, there is clinical evidence is sparse. But the expectation’ when all they under- an Acupuncture Expectancy Scale, letter by Miyata and colleagues nicely stand about acupuncture is trad- already validated in English and demonstrates a possible mechanism: ition, meridians and qi—which Chinese, and now validated here in as the figure 1 shows, EA protects the indicates that they haven’t bothered its Korean version by Chae and col- hair cells in the organ of Corti from to look at the evidence. Less leagues. One way or another, degeneration, at least in an animal extreme is to be embarrassed by the expectations will be clearer. model. fact that much of the effect of acu- Expectancy of a different kind of Sanchez-Araujo and Luckert- puncture seems to come from outcome is high among footballing Barela provide clever insight into the expectation, since ‘real’ acupunc- nations as they head to Brazil for fundamental approach to acupunc- ture effect is not much different the World Cup. The razzmatazz just ture’smodeof action—meridian or from ‘sham’ effect, but both are means more work for the Brazilian nerve. They note that on the trunk, much better than usual treatment. doctors, and the medical students meridians run vertically whereas An alternative explanation is that there are already showing signs of nerves run horizontally. Now trad- sham acupuncture is itself effective, burnout. But Dias and colleagues itional acupuncture books assign which is an understandable argu- have scored already, showing acupuncture points individual func- ment if expectancy doesn’t feel like electroacupuncture (EA) reduces tions: so do these functions follow a ‘real’ or ‘honest’ treatment, and is burnout in students, particularly in the vertical or horizontal lines? See somehow cheating because it is improving their sleep. Da Silva and their comment on ‘cutting the foot open to manipulation. Batigalia net a second goal—treat- to fit the shoe’. Expectancy floats around in these ing de Quervain’s. Two-nil already. Aren’t we all just a little tempted muddy waters, but we try to clarify In another trial, Foroughipour to cut the foot, when reality does some aspects of it with two articles and colleagues find acupuncture not meet our expectations? in this issue: Sherman sets the superior to sham acupuncture for Competing interests None. scene in her editorial. She found migraine prevention in patients Provenance and peer review that, when clinicians manipulate who have not responded to medi- Commissioned; internally peer reviewed. their patients’ expectations, they cation. This is interesting new data try to make them more realistic. since the current evidence only Figure 1 Neuroprotection (A) hair cells in organ of Corti of normal mouse, p75(+/+); (B) hair cells in p75 knockout mice with progressive onset hearing loss, P75(−/−); (C) hair cells in knockout mice after electroacupuncture. White A. Acupunct Med 2014;32:1. doi:10.1136/acupmed-2014-010523 1 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acupuncture in Medicine SAGE

In this Issue

White, Adrian
Acupuncture in Medicine , Volume 32 (1): 1 – Feb 1, 2014
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Publisher
SAGE
Copyright
© 2014 British Medical Acupuncutre Society
ISSN
0964-5284
eISSN
1759-9873
DOI
10.1136/acupmed-2014-010523
Publisher site
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Abstract

Highlights doi:10.1136/acupmed-2014-010523 Adrian White, Editor Expectancy must surely influence And anyway, the evidence varies on shows that acupuncture is superior the response to virtually every whether expectancy does truly to drug prophylaxis, not sham acu- medical treatment for virtually affect the clinical response, and puncture, for safety and effective- every condition—except perhaps a some studies find no effect. This ness for migraine. drug given while the patient is might be due to the context but Expectancy is ‘trending’ in clinical unconscious. And yet the topic of more likely is due to lack of tools acupuncture; neuroprotection is expectancy generates attitude, par- to measure it reliably. Sherman is ‘trending’ in acupuncture mechan- ticularly in acupuncture. involved in a detailed, theoretically isms. Acupuncture is used for deaf- At one end of the scale, some driven development of a new scale ness and tinnitus in the East though people dismiss acupuncture as ‘only for expectancy. Meanwhile, there is clinical evidence is sparse. But the expectation’ when all they under- an Acupuncture Expectancy Scale, letter by Miyata and colleagues nicely stand about acupuncture is trad- already validated in English and demonstrates a possible mechanism: ition, meridians and qi—which Chinese, and now validated here in as the figure 1 shows, EA protects the indicates that they haven’t bothered its Korean version by Chae and col- hair cells in the organ of Corti from to look at the evidence. Less leagues. One way or another, degeneration, at least in an animal extreme is to be embarrassed by the expectations will be clearer. model. fact that much of the effect of acu- Expectancy of a different kind of Sanchez-Araujo and Luckert- puncture seems to come from outcome is high among footballing Barela provide clever insight into the expectation, since ‘real’ acupunc- nations as they head to Brazil for fundamental approach to acupunc- ture effect is not much different the World Cup. The razzmatazz just ture’smodeof action—meridian or from ‘sham’ effect, but both are means more work for the Brazilian nerve. They note that on the trunk, much better than usual treatment. doctors, and the medical students meridians run vertically whereas An alternative explanation is that there are already showing signs of nerves run horizontally. Now trad- sham acupuncture is itself effective, burnout. But Dias and colleagues itional acupuncture books assign which is an understandable argu- have scored already, showing acupuncture points individual func- ment if expectancy doesn’t feel like electroacupuncture (EA) reduces tions: so do these functions follow a ‘real’ or ‘honest’ treatment, and is burnout in students, particularly in the vertical or horizontal lines? See somehow cheating because it is improving their sleep. Da Silva and their comment on ‘cutting the foot open to manipulation. Batigalia net a second goal—treat- to fit the shoe’. Expectancy floats around in these ing de Quervain’s. Two-nil already. Aren’t we all just a little tempted muddy waters, but we try to clarify In another trial, Foroughipour to cut the foot, when reality does some aspects of it with two articles and colleagues find acupuncture not meet our expectations? in this issue: Sherman sets the superior to sham acupuncture for Competing interests None. scene in her editorial. She found migraine prevention in patients Provenance and peer review that, when clinicians manipulate who have not responded to medi- Commissioned; internally peer reviewed. their patients’ expectations, they cation. This is interesting new data try to make them more realistic. since the current evidence only Figure 1 Neuroprotection (A) hair cells in organ of Corti of normal mouse, p75(+/+); (B) hair cells in p75 knockout mice with progressive onset hearing loss, P75(−/−); (C) hair cells in knockout mice after electroacupuncture. White A. Acupunct Med 2014;32:1. doi:10.1136/acupmed-2014-010523 1

Journal

Acupuncture in Medicine – SAGE

Published: Feb 1, 2014

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