NHS will now pay for acupuncture

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NHS will now pay for acupuncture

Postby Game_boy » Wed May 27, 2009 7:43 am UTC

http://news.bbc.co.uk/1/hi/health/8068427.stm

The NHS will now prescribe "complementary medicine" (i.e. untested and possibly damaging), such as acupuncture and spinal manipulation, as part of a plan to give patients "access to a choice of different therapies" in the treatment of lower back pain.

I thought we had clinical watchdogs to stop that sort of thing happening?
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Re: NHS will now pay for acupuncture

Postby fyrenwater » Wed May 27, 2009 8:01 am UTC

You act like acupuncture is like some sort of New Age faith healing bullshit. If it's been used for centuries, there's gotta be something in it that works. It's not "Hmm, what happens if I stab this needle here and see what happens." There's actually a complicated system to it. Pressure point X affects Y part of the body in some way that modern Western science can't explain yet.

There's nothing dangerous about acupuncture unless you're getting it done by someone who has no clue what they're doing. It's like getting surgery, getting a vaccine, or even taking pills. They've all got risks and when done well and in a controlled manner, it's fairly safe.

So what's wrong with funding acupuncture? If pills can't cut it and acupuncture works, then what the hell is wrong with using that? It's not replacing modern medicine, it's "complimentary", just as you posted. I don't see any problem aside from "this isn't accepted in the West yet why the hell are we paying for this bullshit needling 'medicine' thing?"
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Re: NHS will now pay for acupuncture

Postby Gelsamel » Wed May 27, 2009 8:10 am UTC

If it's been used for centuries, there's gotta be something in it that works.


Uhm, no, there doesn't have to be. I could say the same about all the other 'faith healing' bullshits out there, most of those things are described as "ancient techniques" even then "People've been doing it for ages so it must work" is a fallacy.

It's not "Hmm, what happens if I stab this needle here and see what happens." There's actually a complicated system to it.


Go get "100 experts" that aren't related to each other and don't know each other in any way and ask them what that complicated system is and see how close they match. But, once again, something having a "complicated system" doesn't mean it works or is viable vs. other treatments.
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Re: NHS will now pay for acupuncture

Postby Freakish » Wed May 27, 2009 8:25 am UTC

I think there's one theory that is causes endorphins to be released. I think...

I think acupuncture could have something to it. I'm not sure of what studies have been done on it.
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Re: NHS will now pay for acupuncture

Postby Gelsamel » Wed May 27, 2009 8:38 am UTC

Freakish wrote:I think there's one theory that is causes endorphins to be released. I think...

I think acupuncture could have something to it. I'm not sure of what studies have been done on it.


Right, and placebos also release endorphins.


Here is a good review of Acupuncture (admittedly from a skeptic site, but it's all basic sci. method explaining how studies should be taken):
http://www.skepdic.com/skeptimedia/skeptimedia15.html

It also talks about why placebos aren't ethical to use in treatment.
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Re: NHS will now pay for acupuncture

Postby Mat » Wed May 27, 2009 8:38 am UTC

fyrenwater wrote:You act like acupuncture is like some sort of New Age faith healing bullshit. If it's been used for centuries, there's gotta be something in it that works.
No.

It's not "Hmm, what happens if I stab this needle here and see what happens." There's actually a complicated system to it. Pressure point X affects Y part of the body in some way that modern Western science can't explain yet.
The "complicated system" is bullshit. Clinical trials have shown it doesn't matter where the needles go or even if they penetrate the skin at all.http://www.bmj.com/cgi/content/full/338/jan27_2/a3115

There's nothing dangerous about acupuncture unless you're getting it done by someone who has no clue what they're doing. It's like getting surgery, getting a vaccine, or even taking pills. They've all got risks and when done well and in a controlled manner, it's fairly safe.
According to the wikipedia article, theres quite a few risks.

So what's wrong with funding acupuncture? If pills can't cut it and acupuncture works, then what the hell is wrong with using that? It's not replacing modern medicine, it's "complimentary", just as you posted. I don't see any problem aside from "this isn't accepted in the West yet why the hell are we paying for this bullshit needling 'medicine' thing?"
1. It costs money, and there is no conclusive evidence that it is works any better than a placebo
2. It encourages people to trust "alternative" medicine which may lead people to refuse evidence based medicine

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Re: NHS will now pay for acupuncture

Postby Game_boy » Wed May 27, 2009 8:39 am UTC

fyrenwater wrote:You act like acupuncture is like some sort of New Age faith healing bullshit. If it's been used for centuries, there's gotta be something in it that works. It's not "Hmm, what happens if I stab this needle here and see what happens." There's actually a complicated system to it. Pressure point X affects Y part of the body in some way that modern Western science can't explain yet.

There's nothing dangerous about acupuncture unless you're getting it done by someone who has no clue what they're doing. It's like getting surgery, getting a vaccine, or even taking pills. They've all got risks and when done well and in a controlled manner, it's fairly safe.


No... medicine needs scientific proof to show that it i) works and ii) is safe. You can't just assume it's safe on intuition. "some way that... science can't explain yet" is another way of saying "false". If we can't show it's more effective than a placebo, regardless of what mechanism it uses it's not worth applying.

So what's wrong with funding acupuncture? If pills can't cut it and acupuncture works, then what the hell is wrong with using that? It's not replacing modern medicine, it's "complimentary", just as you posted. I don't see any problem aside from "this isn't accepted in the West yet why the hell are we paying for this bullshit needling 'medicine' thing?"


Did you read the article? It IS replacing proven medicine. Patients are given the choice between conventional therapies and this. In medicine, the whole reason we visit doctors is that they know better than us - if we are given choices about our own care we will often make the wrong ones because we don't understand the facts or haven't read the scientific evidence for both ways. And I care because it's MY tax money that's paying for it; there are some very good reasons why it isn't "accepted" such as it not working better than a placebo and the risks not being understood.

If the conventional therapies don't work, by the way, then they shouldn't be used either.

And finally, this opens the door to people demanding even less rigorous and proven therapies like detox or homeopathy. Is NICE suddenly going to approve those in a bid to save more money by not providing real care? One of the reasons our system is better than America is that doctors are not open to manipulation by their patients or drug companies for monetary reasons. This policy changes that, and shows lobbying is just as effective as science to get your treatment recognised.
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Re: NHS will now pay for acupuncture

Postby Gelsamel » Wed May 27, 2009 8:44 am UTC

The worst part is that it's legitimizing acupuncture.

You might say "If placebo works, and the only thing we have to do is remove pain (ie. we're not trying to cure something), then why not?" the problem is that for it to work you have to believe it does work, which requires that authorities say that it is a legitimate process shown to work. And if we say that then we get a whole host of other problems like people asking to be treated by acupuncture for curable conditions.
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Re: NHS will now pay for acupuncture

Postby netcrusher88 » Wed May 27, 2009 10:44 am UTC

You mention spinal manipulation (which I assume is similar to chiropractic medicine) there. There's actually some solid science to it, though it requires more caution and regulation than most governments have seen fit to place on it, at least in the US where doctors are licensed at the state level. Some places you don't need a medical license to be a chiropractor. Some places they're similar to a radiologist or anesthesiologist; they are trained and licensed medical doctors, and their primary field is chiropractic which is additional training on top of med school. A friend of mine is the latter breed, in California.

Acupuncture, I don't know. But if the stated purpose is pain relief, and it achieves pain relief, I suppose I can't argue with it as long as it's performed safely. And doesn't cost more than equally effective traditional methods.
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Re: NHS will now pay for acupuncture

Postby sje46 » Wed May 27, 2009 10:56 am UTC

Acupuncture, I don't know. But if the stated purpose is pain relief, and it achieves pain relief, I suppose I can't argue with it as long as it's performed safely. And doesn't cost more than equally effective traditional methods.

Instead of paying for expensive acupuncture, we can just give them flavored water. Pain relief results, for a lot less of the price!

Seriously, it's a placebo.
Gelsamel wrote:Here is a good review of Acupuncture (admittedly from a skeptic site, but it's all basic sci. method explaining how studies should be taken):
http://www.skepdic.com/skeptimedia/skeptimedia15.html

It also talks about why placebos aren't ethical to use in treatment.
Thank you.
Go get "100 experts" that aren't related to each other and don't know each other in any way and ask them what that complicated system is and see how close they match. But, once again, something having a "complicated system" doesn't mean it works or is viable vs. other treatments.
I'm not sure where I read it (I think maybe in my research methods book), but they had people give acupuncture with trained and untrained people. The trained people used the "complicated systems" and the untrained didn't. The results were the same.
I think that's what it said. I have to go diggin'.

fyrenwater wrote:You act like acupuncture is like some sort of New Age faith healing bullshit. If it's been used for centuries, there's gotta be something in it that works.
Like virgin sacrifices. Every year we sacrifice a virgin, the crops grow! Except two years ago. That's because she was really a lying prostitute who somehow kept her hymen intact.
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Re: NHS will now pay for acupuncture

Postby netcrusher88 » Wed May 27, 2009 11:06 am UTC

sje46 wrote:Instead of paying for expensive acupuncture, we can just give them flavored water. Pain relief results, for a lot less of the price!

Seriously, it's a placebo.

Oh, I know. A 98¢ bottle of aspirin may be an equally effective traditional method, or a $5 bottle of naproxen sodium, or any of the various other dirt cheap over the counter painkillers. Superior on the count of being not a placebo too.
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Re: NHS will now pay for acupuncture

Postby Game_boy » Wed May 27, 2009 12:05 pm UTC

netcrusher88 wrote:Acupuncture, I don't know. But if the stated purpose is pain relief, and it achieves pain relief, I suppose I can't argue with it as long as it's performed safely. And doesn't cost more than equally effective traditional methods.


So we need to show:

i) It does achieve pain relief better than a placebo
ii) It is safe. This means the industry needs to be regulated, or at least those parts of it that accept public money.
iii) It is actually cheaper than the traditional methods

If it fails i) then prescribe a real painkiller. Regardless of its medical effect it will have the placebo effect for most people too. If it fails ii) then don't fund it publicly. And if it fails iii) then carry on with the traditional methods.
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Re: NHS will now pay for acupuncture

Postby fjafjan » Wed May 27, 2009 12:39 pm UTC

protip: When anyone says

Pressure point X affects Y part of the body in some way that modern Western science can't explain yet.


bolded part, be very skeptical. There is one science and Western is not its name.
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Re: NHS will now pay for acupuncture

Postby BlackSails » Wed May 27, 2009 12:43 pm UTC

fyrenwater wrote:You act like acupuncture is like some sort of New Age faith healing bullshit. If it's been used for centuries, there's gotta be something in it that works.


You know what else was used for centuries? Leeches. (and dont give me that shit about them being used today. They are being used for utterly different purposes).

Considering there are studies where sham acupuncture* had the same results as real acupuncture (yet both greater than just a general placebo without needes), I dont see how there is any evidence of acupuncture having any activity whatsoever)

*: Sham acupuncture is acupuncture that follows no particular pattern of ki or whatever.

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Re: NHS will now pay for acupuncture

Postby Gelsamel » Wed May 27, 2009 12:48 pm UTC

BlackSails wrote:*: Sham acupuncture is acupuncture that follows no particular pattern of ki or whatever.


Sham acupuncture can also be ones that follow a pattern but aren't put in deep enough, or that don't even put in needles btw.
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Re: NHS will now pay for acupuncture

Postby BlackSails » Wed May 27, 2009 12:54 pm UTC

Gelsamel wrote:
BlackSails wrote:*: Sham acupuncture is acupuncture that follows no particular pattern of ki or whatever.


Sham acupuncture can also be ones that follow a pattern but aren't put in deep enough, or that don't even put in needles btw.


Yeah, that too. Usually its both.

But regardless, when you can replicate the effects of something by an elaborate placebo, the effect is nothing more than an elaborate placebo effect.

Still, its better than reiki or homeopathy.

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Re: NHS will now pay for acupuncture

Postby Heisenberg » Wed May 27, 2009 1:17 pm UTC

BlackSails wrote:But regardless, when you can replicate the effects of something by an elaborate placebo, the effect is nothing more than an elaborate placebo effect.

That's an assumption. I think you're underestimating the placebo effect. For example, the placebo effect has been shown to effectively treat Parkinson's. To say that acupuncture is as good as a placebo is to say that acupuncture is really very good, but not so good that we can discern whether the results are due to acupuncture or due to placebo. Simply because the effects of a particular treatment are less than or equal to a placebo does not mean that treatment is a placebo.

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Re: NHS will now pay for acupuncture

Postby netcrusher88 » Wed May 27, 2009 1:42 pm UTC

Maybe not, but it means that it's probably not a physiological effect but a psychological one. One definition of placebo from the American Heritage Dictionary is "Something of no intrinsic remedial value that is used to appease or reassure another." A psychological effect to mask a physiological problem doesn't sound like intrinsic remedial value to me.
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Re: NHS will now pay for acupuncture

Postby Crius » Wed May 27, 2009 2:28 pm UTC

I don't see a problem with it.

1. It's only being used when modern medicine has failed to treat back pain. Let's face it - modern medicine sucks at treating back pain.
2. It's safe. According to the wikipedia article, it has a very low occurance of minor side affects, and a practically non-existant occurance of major side effects if done by a trained acupuncturist.
3. It works. You can explain it by the placebo effect, but regardless, it's worked for plenty of people. I'm sure these people have been on actual pills, so I doubt a placebo pill will help them in this case.

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Re: NHS will now pay for acupuncture

Postby Gelsamel » Wed May 27, 2009 2:47 pm UTC

The problem, as I said before, is the legitimizing of a technique which has been shown to be no more effective than placebo at treating things.

Placebo does work (as the article I linked also points out), but when a major medical organization like this recommends acupuncture it sets a precedent in the layman public's mind that acupuncture works to treat things. Then we have more people running around thinking that their chakra is out of wack and they can cure their cancer with needles.
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Re: NHS will now pay for acupuncture

Postby Angua » Wed May 27, 2009 2:58 pm UTC

Crius wrote:I don't see a problem with it.

1. It's only being used when modern medicine has failed to treat back pain. Let's face it - modern medicine sucks at treating back pain.
2. It's safe. According to the wikipedia article, it has a very low occurance of minor side affects, and a practically non-existant occurance of major side effects if done by a trained acupuncturist.
3. It works. You can explain it by the placebo effect, but regardless, it's worked for plenty of people. I'm sure these people have been on actual pills, so I doubt a placebo pill will help them in this case.

This, it does help some people, and I know that it helped my grandfather who suffers from a trapped nerve between his discs or something, so even if it was a placebo, it's better than giving them pain relief meds which eventually increase your tolerance. Also, I know a doctor that refers some people with that type of pain to a chiropractor/acupuncturist, and as it helps them it's a good thing. As a doctor is the one who will be sending these patients for this treatment, they should have made sure that this pain isn't something that can be easily treated, and it won't be prescribed for people with dangerous conditions (like cancer) who will then think that they can be cured.
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Re: NHS will now pay for acupuncture

Postby Gelsamel » Wed May 27, 2009 3:24 pm UTC

It's not those few individual's that get referred for back pain I'm worried about, it's the masses of people that see the legitimizing of acupuncture for back pain as the legitimizing of acupuncture period.
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Re: NHS will now pay for acupuncture

Postby Mat » Wed May 27, 2009 3:44 pm UTC

BlackSails wrote:
Gelsamel wrote:
BlackSails wrote:*: Sham acupuncture is acupuncture that follows no particular pattern of ki or whatever.


Sham acupuncture can also be ones that follow a pattern but aren't put in deep enough, or that don't even put in needles btw.


Yeah, that too. Usually its both.

But regardless, when you can replicate the effects of something by an elaborate placebo, the effect is nothing more than an elaborate placebo effect.

Still, its better than reiki or homeopathy vista
True.

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Re: NHS will now pay for acupuncture

Postby Crius » Wed May 27, 2009 6:24 pm UTC

Gelsamel wrote:It's not those few individual's that get referred for back pain I'm worried about, it's the masses of people that see the legitimizing of acupuncture for back pain as the legitimizing of acupuncture period.


Your health care provider should be focusing on how best to treat you, not how others will mis-interpret his/her actions, though. If modern medicine cannot treat someone's back pain, but acupunture could, that person's health care provider should be honest about that. The alternative is worse, because either that person will seek out acupuncture themselves and be less likely to trust their provider in the future, or they simply continue to suffer.

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Re: NHS will now pay for acupuncture

Postby bigglesworth » Wed May 27, 2009 6:35 pm UTC

The NHS has some part to play in education, of infectious diseases for example, but it is hardly its job to teach people about the scientific method.
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Re: NHS will now pay for acupuncture

Postby Chfan » Wed May 27, 2009 6:40 pm UTC

Doesn't it mostly have to do with a placebo effect? The changes from it are very noticeable when related to pain treatment.
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Re: NHS will now pay for acupuncture

Postby Samp » Wed May 27, 2009 6:48 pm UTC

Crius wrote:
Gelsamel wrote:It's not those few individual's that get referred for back pain I'm worried about, it's the masses of people that see the legitimizing of acupuncture for back pain as the legitimizing of acupuncture period.


Your health care provider should be focusing on how best to treat you, not how others will mis-interpret his/her actions, though. If modern medicine cannot treat someone's back pain, but acupunture could, that person's health care provider should be honest about that. The alternative is worse, because either that person will seek out acupuncture themselves and be less likely to trust their provider in the future, or they simply continue to suffer.


But acupuncture doesn't treat anything! Thats the point! Its hokey magic bullcrap peddled by con artists. This is legitimatizing magic over reality.

As someone else has said, the name for alternative medicine that has been found to work has a name:

Medicine.

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Re: NHS will now pay for acupuncture

Postby fyrenwater » Wed May 27, 2009 6:51 pm UTC

Man, fuck you guys. This is why I can't discuss non-Western science-unproven medicine with anyone. Science encourages looking at things with an open mind, not "NO PROOF = BULLSHIT".

Placebo effects don't explain why acupuncture works for skeptics, non-believers, or animals. Animals would see a needle and go "oh shit this is going to hurt", but then they relax when it goes in. You're telling me a placebo effect is going to work for animals that get acupuncture?
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Re: NHS will now pay for acupuncture

Postby Game_boy » Wed May 27, 2009 7:18 pm UTC

fyrenwater wrote:Man, fuck you guys. This is why I can't discuss non-Western science-unproven medicine with anyone. Science encourages looking at things with an open mind, not "NO PROOF = BULLSHIT".

Placebo effects don't explain why acupuncture works for skeptics, non-believers, or animals. Animals would see a needle and go "oh shit this is going to hurt", but then they relax when it goes in. You're telling me a placebo effect is going to work for animals that get acupuncture?


Anecdotes aren't going to cut it as justification for spending my tax money on this. If you have peer-reviewed papers that show the above then I'll be more than happy to think otherwise.
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Re: NHS will now pay for acupuncture

Postby Crius » Wed May 27, 2009 7:22 pm UTC

Samp wrote:But acupuncture doesn't treat anything! Thats the point! Its hokey magic bullcrap peddled by con artists. This is legitimatizing magic over reality.

As someone else has said, the name for alternative medicine that has been found to work has a name:

Medicine.


Except, you know, when getting acupuncture actually does help with back pain when drugs don't. I'm not particularly concerned whether it's a placebo or chi, as long it can be shown to have results.


@fyrenwater - The skeptic's argument would be that the animal reaction is to the human's expectations. Particularly for dogs and their owners I think. But yeah, this forum isn't particularly friendly to alternative medicine.

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Re: NHS will now pay for acupuncture

Postby BlackSails » Wed May 27, 2009 7:31 pm UTC

fyrenwater wrote:Man, fuck you guys. This is why I can't discuss non-Western science-unproven medicine with anyone. Science encourages looking at things with an open mind, not "NO PROOF = BULLSHIT".

Placebo effects don't explain why acupuncture works for skeptics, non-believers, or animals. Animals would see a needle and go "oh shit this is going to hurt", but then they relax when it goes in. You're telling me a placebo effect is going to work for animals that get acupuncture?


Explain the effectiveness of sham acupuncture.

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Re: NHS will now pay for acupuncture

Postby markfiend » Wed May 27, 2009 7:48 pm UTC

I've been having the same argument on another forum, and I'm basically the lone voice of reason over there. Boy I'm glad to find some like minds on this thread.

(Just for clarification, the like minds I'm talking about are those saying acupuncture is nothing more than placebo.)
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Re: NHS will now pay for acupuncture

Postby Heisenberg » Wed May 27, 2009 8:57 pm UTC

markfiend wrote:(Just for clarification, the like minds I'm talking about are those saying acupuncture is nothing more than placebo.)

So far, only one person has gone that far, probably because there is no evidence to back up your assertion that acupuncture = placebo. However, the majority of posters seem to agree that until repeated trials show that acupuncture can be legitimately differentiated from a placebo, it's not an appropriate venue for taxpayer dollars.

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Re: NHS will now pay for acupuncture

Postby BlackSails » Wed May 27, 2009 9:01 pm UTC

Heisenberg wrote:So far, only one person has gone that far, probably because there is no evidence to back up your assertion that acupuncture = placebo.


http://www.sciencedaily.com/releases/20 ... 101520.htm

Took a 5 second google search. If you have access to JAMA, you can read the actual article.

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Re: NHS will now pay for acupuncture

Postby Heisenberg » Wed May 27, 2009 9:06 pm UTC

Take 5 seconds and read my post. Just because its effectiveness is not measurable against the placebo effect does not mean that a treatment isn't effective. It just means its effectiveness is not provable.

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Re: NHS will now pay for acupuncture

Postby BlackSails » Wed May 27, 2009 9:35 pm UTC

Heisenberg wrote:Take 5 seconds and read my post. Just because its effectiveness is not measurable against the placebo effect does not mean that a treatment isn't effective. It just means its effectiveness is not provable.


Thats basically what ineffective means. Effective means "more effective than placebo"

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Re: NHS will now pay for acupuncture

Postby headprogrammingczar » Wed May 27, 2009 10:53 pm UTC

...unless you want to call placebos effective, in which case, dancing with the TV antenna on your forehead is effective too.
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Re: NHS will now pay for acupuncture

Postby Gelsamel » Thu May 28, 2009 12:21 am UTC

fyrenwater wrote:Placebo effects don't explain why acupuncture works for skeptics, non-believers, or animals. Animals would see a needle and go "oh shit this is going to hurt", but then they relax when it goes in. You're telling me a placebo effect is going to work for animals that get acupuncture?


From the link I posted before:
Okay, Mr. Skeptic, one might say. But if acupuncture is just a placebo, how could it help my dog or horse? Ever hear of Pavlov and classical conditioning? You should look it up. It's also possible that it didn't help your dog or horse, but you perceive it that way to confirm your bias.


Confirmation bias is a huge problem in half-decent studies, let alone anecdotes :-/.
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Re: NHS will now pay for acupuncture

Postby BlackSails » Thu May 28, 2009 12:40 am UTC

Also, as complementary medicine people snake oil salesmen are so keen on reminding scientists, animal studies do not often translate directly to humans.

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Re: NHS will now pay for acupuncture

Postby Jahoclave » Thu May 28, 2009 3:17 am UTC

Gelsamel wrote:
BlackSails wrote:*: Sham acupuncture is acupuncture that follows no particular pattern of ki or whatever.


Sham acupuncture can also be ones that follow a pattern but aren't put in deep enough, or that don't even put in needles btw.

ShamWOW acupuncture features twelve times the bullshit of regular acupuncture. And if you order now you'll not only get a completely ineffective placebo, we'll even include a do it yourself kit. And that isn't all, if you order now you won't pay five easy payments of 19.99. No, you'll pay just three easy payments, a somewhat complicated one, and finally one that is such a bitch you'll never be able to pay it and we'll end up owning your house. ORDER NOW!


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