to us was
NIH Acupuncture Consensus Conference
This commentary is reprinted from the Nov/Dec 1997 newsletter of the National Council Against Health Fraud (NCAHF). The newsletter, along with other general articles and position papers, can be found at the NCAHF website.
The media announced that the National Institute of Health (NIH) had given its blessing to acupuncture following the November 3 to 5, 1997, NIH Consensus Conference. Some sources reported this story as “NIH approval of acupuncture.” To properly interpret this event one must first appreciate the nature of an NIH consensus statement. According to NIH, consensus statements are prepared by a non-advocate, non-Federal panel of experts based upon presentations and discussion at the conference. Such statements are not policy statements of the NIH or the Federal Government. Consensus, on any topic, represents a pooling of opinion. Expert opinion is always a combination of experience, interpretation, and ignorance. A new sound scientific study can cause sudden, dramatic shifts in consensus.
NCAHF’s review of the consensus panel does not give us confidence that it substantially consisted of non-advocates, but even if it were, the conference presentations were clearly unbalanced. When NCAHF reviewed the literature on acupuncture up to 1989, it found a predominance of negative findings. Two major meta-analyses by Riet, et al. that covered the same time period found the same predominance of negative outcomes. The 1993 FDA review of acupuncture was also consistent with the negative findings. We are not aware of any major scientific findings since then that would change the view that acupuncture is mostly a powerful placebo and/or a psychological aid for managing behavioral disorders. The presentations at the conference only strengthened this view.
Most outstanding to us was the absence of negative reports. A balanced program would have contained a representative proportion of negative studies. An objective consensus panel functions much like a jury at a court trial. It bases its verdict upon the evidence that was presented. If one side fails to enter significant adverse data into evidence, the jury cannot be blamed for an erroneous conclusion. To us, the consensus conference appeared strongly biased toward putting the best face possible on acupuncture. The data suggest that acupuncture use by the public is diminishing. Was this a public relations event aimed at marketing acupuncture? The good name of NIH seems to be being abused more and more often to sell the public on the value of scientifically impoverished methods of health care.
Two recent useful articles on acupuncture appeared in Priorities 9:3 (1997): “Not all acupuncture is quackupuncture,” by George Ulett, MD, PhD; and “A bird’s eye view of Chinese medicine,” by Jack Raso. Also, Jane Brody’s coverage of the conference was commendable [New York Times, Health, November 18, 1997].
Riet, et al. 1990. Meta-analysis: acupuncture on addiction; Brit. J. Gen. Pract. 40:379.
Riet, el al. 1990. Meta-analysis: acupuncture and pain. J Clin Epidemiology 43:1191.
Lytle, C. D. 1993.
An Overview of Acupuncture. USDHHS, Public Health Service, FDA Center for
Devices. Radiological Health, May.
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