Recent and Upcoming Meetings and Events
WHO International Classification of Traditional Medicine (ICTM) Annual Network Meeting 2011 was held in Hong Kong during April 2-3, 2011
This was a joint project between the World Health Organization (WHO) technical units of Classifications, Terminologies, and Standards, and Traditional Medicine, and in collaboration with the Quality Assurance and Safety: Medicines unit. The project’s mission is to produce an international standard for information on Traditional Medicine that is ready for electronic health records and that will serve as a standard for scientific comparability and communication. The meeting was held with the support of the WHO Western Pacific Regional Office. For brief video presentations, visit http://youtu.be/1IYTkpJhNGo and http://youtu.be/NVj7XS-WmDU.
American Academy of Medical Acupuncture’s 2011 Symposium Highlights
During April 1-3, 2011, an exciting meeting was held at the yearly gathering of the American Academy of Medical Acupuncture (AAMA). The meeting was comprised of more than 200 participants, including acupuncturists, osteopaths, and medical practitioners. Notable among the numerous high-quality presentations that were made were Dr. Li Xing Lao on acupuncture research, Dr. May Loo on the developmental aspects of acupuncture, Dr. Tan on traditional balancing methods in acupuncture, Dr. Wong on neuroanatomical acupuncture, and Dr. Terry Olsen on ear acupuncture, to mention just a few. Dr. Edwards from the National Center on Complementary and Alternative Medicine (NCCAM) at NIH outlined the institutional themes of research sponsorship, including greater focus, mechanisms and translational tools, real world effectiveness research, and communication. A theme of the meeting was how to enhance communication among acupuncture research and clinical groups to build on the strength of each. For more information or to purchase a recording or syllabus of the conference, visit: http://www.medicalacupuncture.org/
Informing the U.S. Government about Acupuncture Treatment for American Soldiers
SAR Board members Richard Hammerschlag and Richard Harris recently attended a joint NIH/DOD workshop on Acupuncture for Acute Pain. According to Partap Khalsa, a program officer at the National Center for Complementary and Alternative Medicine (NCCAM) at NIH who also attended the event, the workshop was initialized by the DOD because a number of military personnel were performing acupuncture on soldiers, and the DOD wanted to get information from the NIH about acupuncture research. Richard Hammerschlag was involved in spearheading a mechanistic breakout session where potential problems and opportunities for acupuncture research in the military were discussed. Richard Harris was a moderator for one of the sessions.
Symposium for Portland Area Research on Complementary and Alternative - April 16, 2011, in Portland, OR, USA
The Symposium for Portland Area Research on Complementary and Alternative Medicine (SPARC) is Portland's own conference on complementary and alternative medicine (CAM) research. It offers a unique “grass roots” environment where researchers, clinicians and students from different backgrounds and disciplines gather to learn about recent research. The focus of this year's symposium is on mind-body medicine. Margaret Chesney, PhD, Director of the UCSF Osher Center for Integrative Medicine is scheduled as a keynote speaker, where she will present Mind-Body Medicine: Is there Power in Positive Thinking? To learn more, visit: http://www.ncnm.edu/helfgott-research/sparc.php
International Congress on Complementary Medicine Research (ICCMR) 6th International Congress on Complementary Medicine Research: Evidence-Based Decision Making for Traditional and Integrative Medicine (May 7-9, 2011, Chengdu, China)
The International Congress on Complementary Medicine Research (ICCMR) is organized annually by the International Society for Complementary Medicine Research (ISCMR). ISCMR is an international scientific organization of researchers, practitioners and policy makers that fosters Complementary and Integrative Medicine research and provides a platform for knowledge and information exchange to enhance international communication and collaboration. For more information about the event, visit: http://eng.2011iscmr.org
Whole Medicine: Teaming Up for Our Patients (May 13-15, 2011, Baltimore, MD, USA)
This conference is co-sponsored by the University of Maryland School of Medicine Center for Integrative Medicine, The American Association of Acupuncture and Oriental Medicine (AAAOM) and the American Oriental Medicine Institute (AOMI). For more information, visit: www.aaaomonline.org.
Acupuncture in the News
Headline: Health Care for Hell’s Refugees - Reaching Out: Clinic Offers Non-Western Therapies to Torture Survivors
Every hospital harbors the suffering, but most patients at the Complementary and Alternative Medicine Refugee Health Clinic (CAM) in Boston, Massachusetts have lived through a particular hell: they are torture survivors, having endured personal abuse or watched loved ones suffer through it. Two-thirds of the patients undefined CAM has treated about 50undefinedfled war-shredded sub-Saharan Africa, their psyches haunted by memories of family murdered or left behind. To read the full article, visit http://www.bu.edu/today/node/12166. (Reference: BU Today, Campus Life)
Based on the concept of Placebo (Latin “I shall please”), of presenting an inert but similar experience aimed at controlling for positive expectancy of the subject, recent developments suggest this practice requires critical analysis. Multiple excellent research studies, not least the GERAC trials and others, have shown that sham acupuncture is not in fact inert. Yet we continue to present this model as a valid objective research method, leading only to confusion of the reader and consumer of acupuncture. And yet a type of control is needed in the management of complex interactions of clinical practice. We cannot expect that specialists outside of the profession be they regulators, reviewers, or basic scientists answer this question for us. Developing a valid control method should be at the forefront of attention of the acupuncture research community. Perhaps a critical look at this question might form the basis of a future meeting. Does this “sham” effect represent the simple effect of “positive expectancy”, or a physiologic effect of the sham acupuncture itself? How do sham and real acupuncture differ? What constitutes sham needling? What really happens when you put a needle in the skin? And how can the research design support your expected outcome? These are questions that will not be answered by one researcher or group, but will need a concerted multidisciplinary effort.
Additional reading materials:
Low Inter-rater Reliability Confounds Acupuncture Research
According to a recent Norwegian study, acupuncturists do not agree on diagnosis or treatment. Birkeflet et al studied two acupuncturists to determine the inter-rater reliability in Traditional Chinese Medicine (TCM) for female infertility. The two acupuncturists, with 20 years and 6 years of experience respectively, simultaneously interviewed 30 infertile women and 24 fertile women. The practitioners then independently made a TCM diagnosis and point selection. The researchers analyzed the practitioners’ assessments and treatments using the more conservative Kappa Statistic. Thirty-nine different TCM patterns and 36 different acupuncture points were used. For the choice of acupuncture points, poor to no agreement was found. Moderate to fair agreement was seen in excess/deficiency and merged patterns. Perfect match to moderate agreement on treatment was obtained when choosing meridians given certain TCM patterns. They concluded the low agreement on diagnoses indicates that acupuncturists follow individual pattern differentiation processes. The selection of acupuncture points seem to be closely related to the choice of TCM pattern diagnoses. The results indicate that the poor reliability in the diagnoses and thus treatment received by a patient will vary individually, which in turn is a challenge for clinical trials of acupuncture.
(Reference: Birkeflet O, Laake P, Vøllestad N. Low inter-rater reliability in traditional Chinese medicine for female infertility. Acupunct Med 2011; epub ahead of print. Retrieved from http://aim.bmj.com/content/early/2011/01/18/aim.2010.003186.abstract)
Lower Stress and Higher IVF Pregnancy Rates Related to Acupuncture on Day of Embryo Transfer
In an observational prospective cohort pilot study, Balk et al reported patients who elected acupuncture (N=17) had significantly lower perceived stress scores before and after embryo transfer than those who did not have acupuncture (N=40). Further, patients had insignificantly higher pregnancy rates with acupuncture undergoing IVF cycles with non-donor eggs (55.6%, 5/9 vs 35.5% ,11/31, p=0.28) than those who did not. The same was true in patients electing acupuncture for IVF cycles with donor eggs (75.0%, 6/8 vs 66.7%, 6/9, p=0.71). The acupuncture group received the Paulus protocol on the day of embryo transfer and completed the 10-question Perceived Stress Scale. The authors concluded that the acupuncture regimen was associated with less stress both before and after embryo transfer, and it possibly improved pregnancy rates. Lower perceived stress at the time of embryo transfer may play a role in an improved pregnancy rate. (Reference: Balk J, Catov J, Horn B, et al. The relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: A pilot study. Complement Ther Clin Pract. 2010; 16:154-7. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20621276)
Biomedical Diagnosis Makes a Difference in IVF Outcomes with Acupuncture
In a Brazilian randomized controlled trial, researchers examined pregnancy outcomes in patients undergoing an in vitro fertilization – intra-cytoplasmic sperm injection (IVF-ICSI) cycle. Patients were randomized to receive acupuncture (N=208) or no acupuncture (N=208). For those biomedical diagnoses of tubal issues or unexplained infertility, there was a five-fold increase in pregnancy rate (PR) in the acupuncture group versus the control group (OR 5.15, 95% CI 1.03 – 34.5, p=0.04). However when biomedical diagnosis is not taken into account, there was no significant improvement. The acupuncture group pregnancy rate was 40.4% (84/208) compared to the control group 32.2% (67/208, p=0.652). Additionally, the live birth rate 33.7% (70/208) in the acupuncture group compared to 27.4% (57/208, p=0.763) in the control group. Authors’ conclusion was that while acupuncture treatment had no influence when performed immediately before and immediately after embryo transfer, on clinical outcomes overall, in a subgroup analysis, when the embryo was not affected by an ovarian or seminal influence, a benefit was noted. (Reference: Madaschi C, Braga DPAF, Figueira RDCS, et al. Effect of acupuncture on assisted reproduction treatment outcomes. Acupunct Med 2010; 28:180-184. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20959311)
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SAR Newsletter Committee
Jongbae Park, KMD, PhD, L.A
University of North Carolina at Chapel Hill, USA
Brenda Golianu, MD
Stanford University, USA
Sanghoon Lee, KMD, PhD., L.Ac
Kyung Hee University, Korea
Lee Hullender Rubin, DAOM, L.Ac
Oregon College of Oriental Medicine, USA
Naomi Takazawa, L.Ac
Japan Society of Acupuncture and Moxibustion, Japan