Talk:Acupuncture

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Bias in the wording of the Efficacy section[edit]

My main problem is with this section:

"As of 2021 many thousands of papers had been published on the efficacy of acupuncture for the treatment of various adult health conditions, but there was no robust evidence it was beneficial for anything, except shoulder pain and fibromyalgia.[20]."

Problems:

  • If you read up until "no robust evidence that it was beneficial for anything" it basically says that acupuncture is worthless. This is very subtle, but, IMO, a bias in this text.
  • The text makes it look like acupuncture is not useful for anything, except for these 2 things. This is not what the cited source (SOURCE1) says. The source doesn't say that they couldn't find that acupuncture was useful, and instead, one of the main things it says is that research in this area should work towards being more certain than it currently is.
  • In the source, the authors main split was between high-or-moderate-certainty evidence vs low-or-very-low-certainty evidence. Here, the wiki text singles out high-certainty evidence (and names it "robust evidence") which in my opinion is a form of bias. In this aspect, the wiki text is closer to the skeptical article (which also singles out high-certainty evidence) (NOTE1, SOURCE3).
    • To complement the previous point, the source points to another similar paper, by Lu and colleagues (SOURCE2). This paper singles out interventions with large or moderate effects and splits between high-or-moderate-certainty evidence (which it calls "effective") and low-or-very-low-certainty evidence (which it calls "promising but unproven").
  • To present the data, SOURCE1 found:
    • 3 conclusions in which acupuncture was benefitial with high certainty (NOTE2),
    • 28 conclusions in which acupuncture was benefitial with moderate certainty, and,
    • >60 conclusions in which the certainty was low or very-low.
    • (I excluded, for simplicity, the 1 high certainty conclusion and 3 moderate certainty conclusions where acupuncture was found as no better than the comparator)
    • (One interesting thing is that about half of the conclusions where there is high-or-moderate-certainty evidence that acupuncture was effective were about painful conditions or pain outcomes).

I think that if the wiki text had those numbers instead of a "no robust evidence it was benefitial for anything" it would be more informative and less partial.

A reference to the skeptical article can still be maintained below (or maybe even expanded, as it is not clear that it references the source that we're talking about or what the main criticisms towards acupuncture are), providing counter-balance.

Notes:

  • NOTE1: In the text I will be referring to the Science Medicine Based text mentioned in the Efficacy section as "skeptical article" (SOURCE3). You can take it literally, as in it is an article written by a skeptic (Steven Novella, the president of New England Skeptical Society). I don't know much about this world, and I mean no offense in whatever I write here.
  • NOTE2: The wiki text excludes one of the conclusions in which acupuncture was benefitial with high certainty (for stroke), arriving at the number 2 for "robust evidence". This is probably because it was also excluded in the skeptical article. The skeptical article excludes it because it was electroacunpuncture. I will not question whether or not this exclusion should be made in the wiki text.

Sources:

CozyShrimp (talk) 23:57, 24 January 2024 (UTC)[reply]

IMO, a bias
which in my opinion is a form of bias
You seem to be saying that the article is biased because it deviates from your opinion. But that is not the criterion here.
the wiki text singles out high-certainty evidence Well, that is how science is done. Use the good studies, throw away the bad studies. And "good" and "bad" are not defined by outcome.
the wiki text is closer to the skeptical article (which also singles out high-certainty evidence) Good. So, it's how it should be. --Hob Gadling (talk) 07:51, 25 January 2024 (UTC)[reply]
The 'skeptical article' is from WP:SBM, and while it offers some useful commentary, Wikipedia is rather more circumspect that its "most of the acupuncture evidence is crap". What we have looks like a fair summary with respect to the sources. On Wikipedia, Electroacupuncture has a separate article. Bon courage (talk) 07:52, 25 January 2024 (UTC)[reply]
I agree with Hob Gadling and Bon Courage. I also closely considered the quoted sentence from the page, and I don't think that it is written in a biased manner. --Tryptofish (talk) 22:52, 25 January 2024 (UTC)[reply]
My main point previously was that the section had a POV that didn't conform to the data from SOURCE1.
After reading a bit more about Wikipedia policies (I'm a new contributor, so please don't mind me), my main concern now is that it has a POV that is different from the POV found in SOURCE1, and instead leans heavily towards the POV found in SOURCE3, while attributing it to SOURCE1 (I will try working a bit more on this @Bon courage and @Tryptofish). This goes against Wikipedia policies, as we're supposed to keep the POV from the source. If we wanna keep just Steven Novella's POV, I think we could remove the previous section (the one I'm complaining about) and that would be less misleading (this might look exaggerated, but I really believe this).
@Hob Gadling I think you either misunderstood or spun what I said. I'm not arguing about the passage being against acupuncture. I'm arguing about the passage misrepresenting its source (and sorry if that was not clear).
I will research a bit more on this topic (probably about bias, to try to pinpoint a bit clearer), and then maybe get back to this.
Thanks a lot by now :) CozyShrimp (talk) 17:08, 28 January 2024 (UTC)[reply]
I see that you are a new editor, so welcome to Wikipedia! I'm quite confident that I understand the NPOV policy, and that what I'm saying here conforms to it. We're not supposed to keep the POV from any given source, so much as to maintain a neutral POV as reflected by the preponderance of sources. --Tryptofish (talk) 19:49, 28 January 2024 (UTC)[reply]
If you look at the article's own "Key points" as published, then the "Meaning" they give is:

Despite acupuncture having been the subject of hundreds of randomized clinical trials and systematic reviews for dozens of adult health conditions, there were few conclusions that had greater than low certainty of evidence.

Seems well aligned, POV-wise, with what Wikipedia says (but we give a bit more detail). Bon courage (talk) 17:22, 28 January 2024 (UTC)[reply]
Compare:
- "few conclusions that had greater than low certainty of evidence" to "there was no robust evidence it was beneficial for anything, except shoulder pain and fibromyalgia", and,
- "many thousands of papers" to "hundreds of randomized clinical trials and systematic reviews"
The "Conclusions" session of the paper is still a little bit less critical, but, if the same source has 2 slightly different POVs, maybe keep both (not sure, I'm fine with just keeping the above). CozyShrimp (talk) 17:40, 28 January 2024 (UTC)[reply]
Part of the task here is translating dry EBM-speak into something suitable for a non-specialist audience. I think it's done well at the moment. Bon courage (talk) 18:01, 28 January 2024 (UTC)[reply]
Just to finalize this convo now, my impression is that it has been made in a misleading way.
I appreciate the responses, even though we have different POVs on this section of the wiki,I appreciate how clear you've been through this. CozyShrimp (talk) 18:33, 28 January 2024 (UTC)[reply]
@Bon courage Just a question, would you be willing consider an Edit request if I made, just to try to clear up the POVs of SOURCE1 and SOURCE3. I would try to mostly quote SOURCE1 (that, if you look at it, is still critical of acupuncture research), and maybe add something more about SOURCE3. CozyShrimp (talk) 17:21, 28 January 2024 (UTC)[reply]
I don't see any POV that needs "clearing up". We don't cite that BMJ Open paper and it looks like Chinese research on TCM, so that's a red flag. Bon courage (talk) 17:25, 28 January 2024 (UTC)[reply]
By SOURCE3 I mean the one from SBM.
But come on man, I think if I write something, it will be just slightly clearer and it will be easier than discussing some sort of bias (which is hard).
You can reject it w/out problem if you think it ain't better than the previous text :p CozyShrimp (talk) 17:42, 28 January 2024 (UTC)[reply]
I don't have any power or desire to stop you making any request and the content of this article is determined by WP:CONSENSUS (it has had > 2,000 editors in its time). Bon courage (talk) 17:46, 28 January 2024 (UTC)[reply]

Insufficient research[edit]

I think it's important to note there's insufficient research on accupuncture, and more research is needed to get a complete picture. Instead of giving the impression that research has been sufficient and conclusive and that it doesn't work and to let heavy skeptic sources dominate this article. Also the few studies have already yielded empirical results like showing improvement and real brain mapping changes on MRI scans that's not replicated in sham accupuncture, so something is obviously there. https://news.harvard.edu/gazette/story/2017/03/study-reveals-differences-in-the-effects-of-real-and-sham-acupuncture/ I read a generated ChatGPT answer to accupuncture. It presents a far more neutral tone where it acknowledge that some studies suggest it may help with chronic pain and inflammation. But more research is needed for a complete picture. That tone is what's needed in Wikipedia, which is sorely missing. I know ChatGPT is not a real source but it does however present a fair neutral tone that doesn't try to push a pov possibly prematurely that nobody should use acupuncture nor advocates that acupuncture works outright. And I think we should be learning and modelling our tone after it. Generally it notes, " Pain Relief and Inflammation Reduction:* Some studies suggest that acupuncture may help reduce inflammation, which is often associated with chronic pain conditions such as arthritis and fibromyalgia. And most importantly it writes - It's important to note that while many people report positive effects from acupuncture for chronic pain, individual responses may vary, and more research is needed to fully understand its mechanisms and effectiveness for different types of pain conditions. And that's factually fair and correct. As I had written before; science doesn't have the prowess to explain everything. But empirically newer studies show it's not a mere placebo effect. They found that acupuncture — but not sham — changed brain activity in terms of activating the receptors that bind opioids, which help control pain in the body. https://www.washingtonpost.com/wellness/2023/07/24/does-acupuncture-work-chronic-pain/ So I think the philosophy itself is quackery as I don't believe in that. But I do suspect that the effects are real and that should not be dismissed so easily. It's already proven to have long lasting remapping of the brain in MRI scans for real accupuncture vs sham for carpel tunnel syndrome research as I noted in the Harvard Gazette article link above. So philosophy may be illegitimate, but not the physical impacts it gives. Harvard above talks a fair deal on it. And given the empirical evidence, this article should be more neutral and not just turn this article into some kind of skeptic dominated article that tells readers to never believe it and that others are wrong to question this. As Langevin and Wayne, both Harvard Medical School researchers, have suggested that although acupuncture has become more empirically legitimized, it is held back by the theory behind it. The theory is likely wrong but the effects is emerging to be legitimate indeed and why this article needs to reform to be more neutral. Renfieldaccusome (talk) 01:29, 18 March 2024 (UTC)[reply]

Nope, there is a difference: only effects can be debunked, the philosophy can only be disbelieved. Same as there is no way to debunk elves and fairies, most people merely disbelieve them. I mean there are no recent, peer-reviewed scientific studies which offer the ultimate proof that elves and fairies do not exist.
To be more clear: effects are amenable to empirical falsification (Popper), while its philosophy simply does not match the paradigm of mainstream science (Kuhn). tgeorgescu (talk) 01:45, 18 March 2024 (UTC)[reply]
Thank you for your response. I posted here once and actually got many replies and for some reason, that thread is gone despite it was only two months ago I think. Sorry I don't usually use Wikipedia and probably didn't respond to all the replies. But just wanted to revisit a concern that this article needs to improve on its tone. And I propose that it's important to note there's insufficient research on accupuncture, and more research is needed to get a complete picture. Instead of giving the current impression that research has been sufficient and conclusive and that it doesn't work and to let heavy skeptic sources dominate this article. That fair context is missing but it's needed. And I don't think others can argue against including that context. I should repeat despite being few, professional studies have already yielded empirical positive results like showing improvement and real brain mapping changes on MRI scans that's not replicated in sham accupuncture, so something is obviously there. https://news.harvard.edu/gazette/story/2017/03/study-reveals-differences-in-the-effects-of-real-and-sham-acupuncture/ I also read they found that acupuncture — but not sham — changed brain activity in terms of activating the receptors that bind opioids, which help control pain in the body. https://www.washingtonpost.com/wellness/2023/07/24/does-acupuncture-work-chronic-pain/ So like I said, the theory is likely wrong and not going to dispute that. But the effects is emerging to be legitimate indeed and why this article deserves to at least be more open minded and not shut it down completely as impossible to work. Particularly when you consider that recent studies are showing such promising empirical results that can't be explained by mere placebo effect. That's all I am saying and hope you don't misunderstand. Renfieldaccusome (talk) 01:50, 18 March 2024 (UTC)[reply]
tgeorgescu, where do you find the patience? Drmies (talk) 01:51, 18 March 2024 (UTC)[reply]
@Drmies: I have lost my patience for repeating the same mantras, but sometimes I do find a newer approach. tgeorgescu (talk) 01:56, 18 March 2024 (UTC)[reply]
Is it okay to to use such a tone against other editors like this? I was just stating that research hasn't been conclusive but there's been enough promising empirical evidence to justify a more neutral tone. I already provided enough proof above in the links, which shows that real accupuncture differs from sham and has real hard results.Renfieldaccusome (talk) 02:12, 18 March 2024 (UTC)[reply]
Just in case I wasn't clear: I'm tired of me repeating the same mantras about WP:RULES. Often because I suspect that not all those who claim they are newbies are really newbies. So, I feel like I'm wasting my time, while troublemakers get a new IP or wait three months for their private data to expire. tgeorgescu (talk) 04:59, 18 March 2024 (UTC)[reply]
I see. I been busy and haven't even commented on this page for 2 months and assure you I am not them.
If you believe certain users are causing trouble then you should report their behaviour to Wikipedia admin for further investigation. But it's important to not make assumptions of users. I have not said anything unkind to you nor refusing to listen to your replies. And please don't misunderstand me. I have read this article from Washington Post, https://www.washingtonpost.com/wellness/2023/07/24/does-acupuncture-work-chronic-pain/ that cites a 2018 meta-analysis of over 20,000 patients in 39 high-quality randomized controlled trials found that acupuncture was superior to both sham and no acupuncture for back or neck pain, osteoarthritis, headaches and shoulder pain. And am also aware there are experts saying more evidence is needed to confirm this. But this is very different to what the current article is saying. And is why I only propose to include in the article that "researchers emphasize the need for more high-quality evidence to establish any effectiveness conclusively", instead of simply saying that it doesn't work and that it's a conclusive finding from sufficient evidence. Which is false. Renfieldaccusome (talk) 07:09, 18 March 2024 (UTC)[reply]
Renfieldaccusome, please stop mansplaining. Drmies (talk) 12:34, 18 March 2024 (UTC)[reply]
@Renfieldaccusome this is more pro-acupuncture POV-pushing based on non-WP:MEDRS sources. We already summarize the science well: despite the vast, vast, swathes of research there is little, if any, signal in the noise. As a matter of style, Wikipedia avoids the FRIN-like wording you are proposing. Bon courage (talk) 07:11, 18 March 2024 (UTC)[reply]
Thanks for your input. I agree it's important to maintain a balanced and evidence-based approach in our content. But National Institutes of Health (NIH) is from the US government and also the Journal of Pain, which I read is a peer-reviewed medical journal published by the American Pain Society. Those are not considered a good source for Wikipedia? If that is so, then that's surprising. Technically I see a very old study cited in Journal of Pain in the article right now. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154967/ So why even cite them today, despite they are so old, if they are as you claim the organisation is not neutral? The more recent studies such as 2018, published by that same journal had showed different conclusion, yet is not mentioned but they stated they confirmed that acupuncture has a clinically relevant, persistent effect on chronic pain that is not completely explained by placebo effects. What proof is there that American Pain Society are now even biased on their more recent studies and unacceptable? That 2018 study is still available to view on the US Gov national library of Medicine website today and has not been retracted. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5927830/ Renfieldaccusome (talk) 08:14, 18 March 2024 (UTC)[reply]
See WP:MEDFAQ#PUBMEDRIGHT. We currently cite just one article in the efficacy section. There is no need to cherry pick older meta-analyses. Bon courage (talk) 08:21, 18 March 2024 (UTC)[reply]
We currently cite just one article in the efficacy section. Do you mean this one? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9685495/ Its main argument is saying what I have been saying and better. It writes; Despite the large literature on acupuncture, most reviews concluded that their confidence in the effect was limited. Thus, the most important research need is for better evidence to move these certainty-of-evidence assessments upward, such that clinicians, patients, and policy makers can have more confidence that acupuncture does, or does not, have benefit for a certain health condition." And "The field of acupuncture would be best moved forward with resources devoted to producing more high quality randomized clinical trials and producing fewer new systematic reviews" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9685495/ In other words, it itself is saying it's challenging to draw firm conclusions about the true effects of acupuncture based on the available evidence and studies. And there is currently a general lack of high quality randomized clinical trials being repeated again. Your respected source itself also adds that there is a need for more high quality randomized clinical trials (such as the relative newer large one in 2018). It wouldn't say this unless acupuncture already has enough high quality studies confirming its effectiveness or not, and so even your respectable source supports what I have proposed. Renfieldaccusome (talk) 10:04, 18 March 2024 (UTC)[reply]
The research will only be "sufficient" for acupuncture believers if the result of the research is "it works". As long as the result is "we found no robust effect", it will be "insufficient". It's the same for every other pseudoscience. --Hob Gadling (talk) 08:24, 18 March 2024 (UTC)[reply]
In your respectable source now cited in the article's efficacy section. It says the certainty of evidence is low or very low, but that does not necessarily mean that acupuncture does not work. It means there are limitations or weaknesses in the study design, data quality, or other factors that decreases professional confidence in the findings. And that's unsurprising as a lot of older studies are poor quality and there is currently a lack of high quality randomized clinical trials like the one more recent in 2018, which makes a minority. It demands more high quality studies and less reviews that is merely rehashing the older poor quality studies. However I would concede that a lack of evidence and high quality studies doesn't also mean that accupuncture works. So I would leave the article as it is and wait for further new higher quality studies to surface and then be reviewed later, which would either confirm if it works or not with higher improved certainty. Thank you for the discussion; let's conclude here. Renfieldaccusome (talk) 10:16, 18 March 2024 (UTC)[reply]
Stop wasting our time now. We have even a meta review of other meta reviews (PMID 36416820).
And stop using this "if not really really really disproved, maybe it still works" BS. It is the other way around: Unless efficacy is not proven, you cannot claim any benefit.
Go now to WP:STICK and good bye.--Julius Senegal (talk) 20:56, 18 March 2024 (UTC)[reply]

Semi-protected edit request on 29 May 2024[edit]

I would like to see some updated and specific data related to recent research and coverage for acupuncture in the United States Sam Collins 33 (talk) 19:05, 29 May 2024 (UTC)[reply]

Sam Collins 33 please don't dump massive walls of text that are copied directly from websites or published articles here - WP:COPYVIO covers this. Now, if you are going to make an edit request, you need to be specific - 'change X to Y', supported by a particular source. You don't need to copy the contents of the source here, you can just link to it. However, it looks like you are asking for sweeping changes to be made to the article, and an edit request isn't really suitable for that. You're going to need to discuss the changes you want to see made here, and the sourcing, and gain consensus for the change. Girth Summit (blether) 19:13, 29 May 2024 (UTC)[reply]
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