Journal of the Royal College of Physicians of London
Allergy is an exaggerated response of the immune system to external substances. It plays a role in a wide range of diseases. In some, such as summer hayfever, the symptoms are entirely due to allergy. In other conditions, particularly asthma, eczema and urticaria, allergy plays a part in some patients but not all. In these situations, allergy may either have a major role or provide just one of many triggers. In an individual patient's illness, the importance of allergy may change with time.
A literature search revealed 51 controlled clinical studies on the effectiveness of acupuncture in chronic pain. These studies were reviewed using a list of 18 predefined methodological criteria. A maximum of 100 points for study design could be earned in four main categories: (a) comparability of prognosis, (b) adequate intervention, (c) adequate effect measurement and (d) data presentation. The quality of even the better studies proved to be mediocre. No study earned more than 62% of the maximum score.
The British Journal of General Practice: The Journal of the Royal College of General Practitioners
A literature search revealed 22 controlled clinical studies on the efficacy of acupuncture in three fields of addiction: cigarette smoking (15), heroin (five), and alcohol (two). These studies were reviewed using a list of 18 predefined criteria of good methodology. A maximum of 100 points for study design could be earned, divided over four categories: comparability of prognosis; adequate intervention; adequate effect measurement; and good data presentation. The study design was generally poor. No study earned more than 75 points and 12 studies (55%) earned less than 50 points.
A critical appraisal of the design of clinical trials which examined the effectiveness of various interventions in fibrositis was conducted. Therapeutic interventions included physical fitness, biofeedback, acupuncture, dothiepin, imipramine, cyclobenzaprine, S-adenosylmethionine and amitriptyline. The design and analysis of the randomized, controlled studies render their results reliable. Major areas for methodologic improvement in future trials were identified. Standardized, validated and reliable diagnostic and outcome criteria need to be established.
Results of 14 randomized controlled trials of acupuncture for chronic pain were pooled in a meta-analysis and analysed in three subgroups according to site of pain; and in two subgroups each according to type to trial, type of treatment, type of control, 'blindness' of participating agents, trial size, and type of journal in which results were published. While few individual trials had statistically significant results, pooled results of many subgroups attained statistical significance in favour of acupuncture.
In a systematic review of the efficacy of interventions intended to help people stop smoking, data have been analyzed from 188 randomized controlled trials. Following personal advice and encouragement to stop smoking given by physicians during a single routine consultation, an estimated 2% (95% confidence limits, 1%, 3%; P < .001) of all smokers stopped smoking and did not relapse up to 1 year as a direct consequence of the advice. The effect is modest but cost-effective: the cost of saving a life is about $1500.
PURPOSE: To review the efficacy of nonmedicinal, noninvasive therapies in hip and knee osteoarthritis. DATA SOURCES: Search of English-language literature from 1966 through 1993 using MEDLINE by cross-referencing "osteoarthritis" (therapy subheadings) with "controlled trial," "comparative study," or "trial(s)." STUDY SELECTION: Fifteen controlled trials of diathermy (deep heat), exercise, acupuncture, transcutaneous electrical nerve stimulation, topically applied capsaicin, low-energy laser, and pulsed electromagnetic fields were found.
BACKGROUND: A number of different therapies have been used for postherpetic neuralgia. We decided to conduct a systematic review of existing randomized controlled trials. OBJECTIVE: To determine the efficacy of available therapies for relieving the pain of established postherpetic neuralgia. METHODS: We performed a systematic review, including meta-analysis, of existing randomized controlled trials. Eleven published trials and one unpublished trial were identified which met the inclusion criteria and were included in the current review.
Quality assurance for acupuncture therapy requires a good basic and on-going training in both conventional western medicine as well as in the theory and practice of acupuncture, the ability to synthesize the patient's objective findings and subjective feelings, and honesty with the patient and towards oneself. Thus, based on the continuous critical evaluation of the objective and subjective parameters, the question of acupunture as the optimal form of therapy for this specific case is honestly answered and one has the courage to admit failures.