An alternative to sham?
For reasons I discussed in another post, research on whether acupuncture “works” is bedevilled by the difficullty of finding a control procedure that doesn’t actually do anything. A different approach to the testing of treatments is to use patients as their own controls. This is not often done but it remains a possibility. The idea is to study individuals with long-term symptoms and compare what happens when they are receiving treatment to when they are not. In a paper titled “Patients as their own controls in studies of therapeutic efficacy: Can we trust the results of non-randomized trials?”, Noel S. Weiss and Susan R. Heckbert (Journal of General Internal Medicine July 1988, Volume 3, Issue 4, pp 381–383) endorsed it.
This approach has the potential to provide a valid measure of efficacy if the condition being treated is chronic, if the effect of the therapy given prior to the first evaluation of patient status does not linger into the second period of the study, and if the means by which the evaluation of patient status is performed at the two points in time are comparable.
I want to describe a case of this kind. The patient is myself so I can’t claim any kind of objectivity, but I think the long period of observation makes it interesting. Anyway, for what it’s worth, here it is. Continue reading “An instructive (personal) acupuncture case”