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Editor's Correspondence
March 10, 2008

Acupuncture Trial Lacks A Priori Rationale to Refute Null Hypothesis

Arch Intern Med. 2008;168(5):550-551. doi:10.1001/archinte.168.5.550-b

Haake et al1 reported that they observed no difference in outcomes between acupuncture and “sham acupuncture” in patients with chronic low back pain. Failing to observe a difference in outcomes, the null hypothesis stands: H0 = the exposures are not different.

In fact, both the acupuncture and “sham acupuncture” treatment arms involved inserting needles into the patients and no a priori biological rationale or explanation was offered to justify the proposition that the exposures were truly different. The investigators failed to explain why standard needling at established acupuncture points might produce a different outcome from minimal needling at nearby locations (“outside Chinese meridians”2). Despite certain extant beliefs about acupuncture, it has been observed that the specific means and methods of point stimulation used in acupuncture practice are of low importance.3

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