Acupuncture Evidence Report

Proving the Effectiviness of Acupuncture

The Acupuncture evidence report is a research analysis published in February 2017. It was undertaken to show there is a lot of evidence to support Acupuncture is a viable treatment for many conditions, musculo-skeletal and beyond.  The report shows that the effects of Acupuncture can no longer be said to just be ‘placebo’, and shows varying effectiveness rates for 117 conditions.

The following is cited from: McDonald J, Janz S. The Acupuncture Evidence Project: A Comparative Literature Review (Revised Edition). Brisbane: Australian Acupuncture and Chinese Medicine Association Ltd; 2017.

Full copies of the report are available on the AACMA website.

Conditions with strong evidence supporting the effectiveness of acupuncture

Reviews with consistent statistically significant positive effects and where autho rs have recommended the intervention. The quality of evidence is rated as moderate o r high quality.

Allergic rhinitisKnee osteoarthritis
chemotherapy-induced nausea and vomitingMigraine Prophylaxis
Chronic lower back painPostoperative nausea and vomiting
Headache (Tension and Chronic)postoperative pain

Conditions with moderate evidence supporting the effectiveness of acupuncture

Reviews reporting all individual RCTs or pooled effects across RCTs as positive, but the reviewers deeming the evidence insufficient to draw firm conclusions. The quality of evidence is rated as moderate or high quality.

Acute lower back painMenopausal Hot Flushes
Acute strokeNeck pain
Ambulatory anaesthesiaObesity
AnxietyPerimenopausal & postmenopausal insomina
Asthma in AdultsPlantar heel pain
Back/Pelvic pain in pregnancyPost-stroke insomnia
Cancer PainPost-stroke shoulder pain
ConstipationPost-stroke spasticity
Depression (with antidepressants)Post-traumatic stress disorder
Dry EyeProstatitis pain/chronic pelvic pain syndrome
Hypertension (with medication)Restless leg syndrome
InsomniaSchizophrenia (with antipsychotics)
Irritable Bowel SyndromeSciatica
Labour PainShoulder inpingement syndrome
Temporomandibular pain

The following is reprinted from the AACMA website:

Background

Evidence of effectiveness underpins the validity of all health care interventions. Acupuncture has been practised for thousands of years; research into its effectiveness and cost effectiveness is in its relative infancy. The Australian Acupuncture and Chinese Medicine Association Ltd (AACMA) identified the need for an updated review of the literature with greater rigour than was possible in the past and commissioned The Acupuncture Evidence Project.

Methods

This review draws on two prior comprehensive literature reviews, one conducted for the Australian Department of Veterans’ Affairs (DVA) in 2010 and another conducted for the United States Department of Veterans Affairs (USVA) in 2013 (1, 2). The research identified by these reviews was pooled, then a search of further literature from 2013 to 2016 was conducted.

Trials were assessed using the National Health and Medical Research Council (NHMRC) levels of evidence, with risk of bias assessed using the Cochrane GRADE system (3, 4). Results have been tabulated to indicate not just the current state of the evidence, but to indicate how the quality and quantity of evidence has changed from 2005 to 2016.

In this review, 122 conditions across 14 broad clinical areas were identified and, of these, only five conditions rated at ‘no evidence of effect’. Evidence of cost-effectiveness was identified for 10 conditions, and evidence for safety was identified for nine conditions. The level of evidence was found by this review to have increased for 24 conditions.

It has been estimated that there is a 17-year time lag in translating clinical research into clinical practice (5). During this time patients are being deprived of the benefit of a proven therapy. Health policy makers now have eight clear conditions associated with a significant burden of disease where acupuncture should be integrated into current clinical guidelines without further delay. Placebo-controlled clinical trials consistently underestimate the true effect size of acupuncture (as discussed in section 1.4), yet they have still demonstrated NHMRC Level I evidence for the effectiveness of acupuncture for a further 109 conditions. This review has found a significant improvement in both the quality of studies and the levels of evidence supporting acupuncture since the most recent reviews conducted by the Australian and US Departments of Veterans Affairs.

 

References

1.      Biotext. Alternative therapies and Department of Veterans’ Affairs Gold and White Card arrangements,. In: Australian Government Department of Veterans’ Affairs, editor.: Australian Government Department of Veterans’ Affairs; 2010.

2.      Hempel S, Taylor SL, Solloway MR, Miake-Lye IM, Beroes JM, Shanman R, et al. VA Evidence-based Synthesis Program Reports.  Evidence Map of Acupuncture. Washington (DC): Department of Veterans Affairs; 2014.

3.      National Health and Medical Research Council. NHMRC additional levels of evidence and grades for recommendations for developers of guidelines. National Health and Medical Research Council; 2009.

4.      Balshem H, Helfand M, Schunemann HJ, Oxman AD, Kunz R, Brozek J, et al. GRADE guidelines: 3. Rating the quality of evidence. Journal of clinical epidemiology. 2011 Apr;64(4):401-6.

5.      Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. Journal of the Royal Society of Medicine. 2011 Dec;104(12):510-20.