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Medical Forum / Diseases and Disorders / Tinnitus / April 2005Which kind of controlled study should we subscribe to?
The following is from the link: http://www.internethealthlibrary.com/Health-problems/Tinnitus%20-%20researchAltT herapies.htm#Acupuncture "There are also controlled research studies which have concluded that acupuncture is a "valuable therapeutic alternative in tinnitus"(3). snipped... (3)Acupuncture for tinnitus management. Nilsson S; Axelsson A; Li De G Department of Audiology, Sahlgrenska Hospital, Gothenburg, Sweden.Scand Audiol (SWEDEN) 1992, 21 (4) p245-51 [Acupuncture is a valuable therapeutic alternative in tinnitus] Akupunktur vardefullt behandlingsalternativ vid tinnitus. Lindholm S; Berg S; Larsson B; Hybbinette JC Avdelningslakare, lanssjukhuset i Kalmar. Lakartidningen (SWEDEN) Mar 6 1991, 88 (10) p847-9 ====================================== So is this kind of 'controlled' study about as good as the ones cited around in ast? Which kind should I believe? After all, all of them are 'scientists'! TRUTH IS INDISPUTABLE WHILE THE 'RESULT' FROM ONE STUDY OR ONE KIND OF STUDY COULD BE CONTRADICTED BY THE 'RESULT' FROM ANOTHER OR ANOTHER KIND OF STUDY(FP's Law). > The following is from the link: > [quoted text clipped - 20 lines] > STUDY COULD BE CONTRADICTED BY THE 'RESULT' FROM ANOTHER OR ANOTHER > KIND OF STUDY(FP's Law). The author makes the statement you quote above but the footnote (which you also quote) doesn't include anything regarding a controlled study. I'm ready for the truth when you are, Francis. > The following is from the link: > [quoted text clipped - 16 lines] > around in ast? Which kind should I believe? After all, all of them > are 'scientists'! Really? What can you tell us about the controls and other variables in place, and about how the relief was measured, since you've read it? Susan http://www.acupuncture.com/Research/Tinn.htm > http://www.acupuncture.com/Research/Tinn.htm Ok, then, let's take a look at the results: "Abstract: Fifty-six patients with continuous and severe tinnitus as their major complaint were treated with traditional Chinese acupuncture. After a pre-treatment period with baseline evaluation of tinnitus, 10 treatments were given during a period of 20 days, followed by a post-treatment period in order to obtain indications of prolonged treatment effects. Assessments were made using visual analogue scales (VAS) and a verbal retrospective rating scale. Three patients reported improvement which lasted for at least 10 days after the last treatment, indicating a possible long-term effect in some cases. Twenty-one percent of the patients reported transient intensity reductions lasting for hours/days. Estimated 'substantial' improvement rate by VAS, consistent for all three parameters involved (intensity, annoyance, awareness), was 20%, while the corresponding deterioration rate was 25. Statistical analysis of the whole group did not show any significant general treatment effects. Interactions between treatment evaluations by verbal rating and VAS are discussed as well as interactions with psychological components. " We see that 3 patients (out of 56) reported improvement which lasted for at least 10 days after the last treatment. We learn that there was no control group. We see that this was not a double blind study. We learn that they looked at and talked to each patient. We learn that the 20 percent of the patients were, by their measure, improved and 25 percent of the patients suffered a setback. Absent a control group, this study is meaningless. On 4/4/05 4:14 PM, in article 9Tj4e.729$q3.36794@news7.onvoy.net, "Bill" > We see that 3 patients (out of 56) reported improvement which lasted for at > least 10 days after the last treatment. We learn that there was no control > group. We see that this was not a double blind study. We learn that they > looked at and talked to each patient. We learn that the 20 percent of the > patients were, by their measure, improved and 25 percent of the patients > suffered a setback. Besides, Bora Bora juice comes with a money back guarantee - it is guaranteed to be as effective as any placebo. Dr. Is this study good enough for patients to try acupuncture for tinnitus after exhausting all they have found http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9 604636&dopt=Abstract Do you have tinnitus yourself, Dr. Grossan? Rather than continuing to intellectualize, you should go to China and ask to be referred to a couple of top-gun acupuncturists and try it out yourself. Then come back and report to all of us. Jim and Dr. Nagler should do the same time also. I once read the website of Dr. Nagler in which he described his experience with acupuncture as one in which his feet were 'full of holes'. Well, he must have gone to visit a chinatown graduate from San Francisco! FP > Dr. Is this study good enough for patients to try acupuncture for > tinnitus after exhausting all they have found [quoted text clipped - 14 lines] > > FP The best way to insure your acupuncturist is doing a good job is to first go to China with Francis and have a "top gun" insert needles in those places that provide tinnitus relief. Carefully mark these punctures with a permanent tattoo mark. Then, when you get back, just make certain whoever treats you drives his spikes at those points. On 4/5/05 10:59 AM, in article 1112723966.180253.122800@z14g2000cwz.googlegroups.com, "fyfpoon@hotmail.com" > Dr. Is this study good enough for patients to try acupuncture for > tinnitus after exhausting all they have found [quoted text clipped - 15 lines] > > FP No I don't have tinnitus myself. You can be a good obstetrician even if you are male. Before I can recommend something to my patients I have to be as certain as I can be that this is the best I can recommend. That's the only reason why people spend their hard earned money and valuable time to visit me. If they didn't want that they could read the internet themselves. Remember, I am in Los Angeles and more than 1/2 my new patients have had most of the "new age " therapies before I see them . I think the "controlled studies " topic has been beaten to death but I do want to point out that few of the studies measured hearing or measured tinnitus. I am well aware that if I tell the patients with a firm voice, "this medicine will make you well!" that this will add considerably to the theraputic effect. But in order to find out if the therapy is actually working, I usually don't do this. But that way I can distinguish the placebo from the physiological effect which certainly helps my patients. Actually I missed my chance. I should have purchased a chinese throne, dressed up a chinese friend in the authentic costume, put the room into soft light and chinese music, then brought the patient in and have the chinese expert point to the theraputic areas. Too late now. You CAN get tinnitus relief with a rabbit's foot. Anything that lowers the anxiety reinforcement cycle can be theraputic. >I think the "controlled studies " topic has been beaten to death but I do >want to point out that few of the studies measured hearing or measured >tinnitus. And not one paid any attention to the state of the neck and/or shoulder muscles. Elly's Tinnitus Resources http://eebee.net/ "fyfpoon@hotmail.com" <fyfpoon@hotmail.com> wrote in part: >http://www.acupuncture.com/Research/Tinn.htm Again, not a controlled study.  SignatureJim Chinnis / Warrenton, Virginia, USA Want to discuss Meniere's? See http://groups.yahoo.com/group/MenieresDG > "fyfpoon@hotmail.com" <fyfpoon@hotmail.com> wrote in part: > >>http://www.acupuncture.com/Research/Tinn.htm > > Again, not a controlled study. Unless I missed something, this study suggests acupuncture does more harm than good. "Bill" <Bill@myplace.now> wrote in part: >> "fyfpoon@hotmail.com" <fyfpoon@hotmail.com> wrote in part: >> [quoted text clipped - 4 lines] >Unless I missed something, this study suggests acupuncture does more harm >than good. Can't tell without a control group. SignatureJim Chinnis / Warrenton, Virginia, USA Want to discuss Meniere's? See http://groups.yahoo.com/group/MenieresDG > "Bill" <Bill@myplace.now> wrote in part: > [quoted text clipped - 8 lines] > > Can't tell without a control group. Right, but didn't it say 20% got better, 25% got worse? Not that those numbers mean squat, but they make me wonder why anyone would point to that study and say acupuncture works on tinnitus. "Bill" <Bill@myplace.now> wrote in part: >> "Bill" <Bill@myplace.now> wrote in part: >> [quoted text clipped - 12 lines] >numbers mean squat, but they make me wonder why anyone would point to that >study and say acupuncture works on tinnitus. Yeah...and overall they say, "Statistical analysis of the whole group did not show any significant general treatment effects." Of course, it was also offered up here as a controlled study, I guess, which it isn't. SignatureJim Chinnis / Warrenton, Virginia, USA Want to discuss Meniere's? See http://groups.yahoo.com/group/MenieresDG On 4/4/05 7:37 PM, in article eau351hfq1dhatf13leikd22eriu50nek6@4ax.com, > "Bill" <Bill@myplace.now> wrote in part: > [quoted text clipped - 20 lines] > Of course, it was also offered up here as a controlled study, I > guess, which it isn't. Care and concern by the caregiver is always helpful to whatever ails the patient. In the early days of biofeedback, each researcher took pains NOT to give personal support , encouragement, in order to determine if this therapy really worked or was it the attention and concern of the researcher. One of my friend did a study of a type of therapy. His results were useless because of his real concern for his patients. Patients just felt better no matter which therapy he applied. "fyfpoon@hotmail.com" <fyfpoon@hotmail.com> wrote in part: >The following is from the link: > [quoted text clipped - 20 lines] >STUDY COULD BE CONTRADICTED BY THE 'RESULT' FROM ANOTHER OR ANOTHER >KIND OF STUDY(FP's Law). Truth my be indisputable, but authors can lie. There was no control group in the "controlled study" you cite: Scand Audiol. 1992;21(4):245-51. Related Articles, Links Acupuncture for tinnitus management. Nilsson S, Axelsson A, Li De G. Department of Audiology, Sahlgrenska Hospital, Gothenburg, Sweden. Fifty-six patients with continuous and severe tinnitus as their major complaint were treated with traditional Chinese acupuncture. After a pre-treatment period with baseline evaluation of tinnitus, 10 treatments were given during a period of 20 days, followed by a post-treatment period in order to obtain indications of prolonged treatment effects. Assessments were made using visual analogue scales (VAS) and a verbal retrospective rating scale. Three patients reported improvement which lasted for at least 10 days after the last treatment, indicating a possible long-term effect in some cases. Twenty-one percent of the patients reported transient intensity reductions lasting for hours/days. Estimated 'substantial' improvement rate by VAS, consistent for all three parameters involved (intensity, annoyance, awareness), was 20%, while the corresponding deterioration rate was 25%. Statistical analysis of the whole group did not show any significant general treatment effects. Interactions between treatment evaluations by verbal rating and VAS are discussed as well as interactions with psychological components. PMID: 1488611 [PubMed - indexed for MEDLINE] SignatureJim Chinnis / Warrenton, Virginia, USA Want to discuss Meniere's? See http://groups.yahoo.com/group/MenieresDG > "fyfpoon@hotmail.com" <fyfpoon@hotmail.com> wrote in part: > [quoted text clipped - 25 lines] > Truth my be indisputable, but authors can lie. There was no > control group in the "controlled study" you cite: OK, Jim, I have just enough time to take you on this one. (1)Has the author lied? This is a dangerous assumption to make, especially when it is done by pretigious schools. (2)Regardless whether or not the study is 'controlled' or not controlled by your standard, it is nevertheless a study or a kind of study in which the reaction of the patients is measured 'scientifically'. Right? And the reaction is that some patients do have their t sound cut down! This may be a small percentage but nevertheless there is a cause and effect relationship there amongst these patients between acu treatment and t sound reduction. (3)The study uses 10 treatments in 20 days as opposed to my own experience in which I used only ONE in a week for 6 months with 2 acupuncturists. So the frequency of the use of this treatment is also a point for a debate. Perhaps the other patients that initially reacted to acutreatment poorly might have gained more improvement if more time had been given or might react more positively if they had been treated with wider time intervals. My 2 experts told me that it is destructive to be treated day after day. Then the question comes. Should we take this result as a reference benchmark to recommend patients to try acupuncture for their tinnitus or should we tell the patients not to try because this kind of study is not good enough? If I had taken the cited 'controlled' study in ast, I would not have gone for acutreatment, and life for me would still have been a living hell. I would recommend other audience in ast to try acu-treatment if they had already tried every scientific methods under the sun and had not found them helpful at all! FP ============================================= > Scand Audiol. 1992;21(4):245-51. Related Articles, Links > [quoted text clipped - 28 lines] > Jim Chinnis / Warrenton, Virginia, USA > Want to discuss Meniere's? See http://groups.yahoo.com/group/MenieresDG A sham, fake treatment and the authentic treatment which are double blinded.
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