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October 13, 1999

Moxibustion for Breech Presentation

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;282(14):1329-1330. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-14-jbk1013

To the Editor: Drs Cardini and Weixin1 present tantalizing results on moxibustion for breech presentation but they fail to convince me that they did not need to conduct a sham-controlled, blinded study. They try to persuade the reader that "because the main results . . . are of a qualitative type and were measured objectively . . . lack of blinding and a placebo does not undermine the validity of the results." However, there is much evidence showing that qualitative and objective data are influenced by the placebo effect.2 Second, it is not difficult to imagine that in an open trial of any therapy vs no therapy, patients receiving the treatment may adopt behaviors different than those not receiving it. This would effectively abolish the effect of randomization since the groups would differ in more respects than just the intervention. In my view, Cardini and Weixin have failed to provide a conclusive answer.

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