Studies on the News Often times we hear studies on the news. And they are confusing. We hear things like coffee is bad and then…

Studies on the News 

Often times we hear studies on the news. And they are confusing. We hear things like coffee is bad and then we hear its good. Or we should eat more of this, then we hear not to eat that. The reason for this is confounding variables and P-hacking. 

Observational studies generally look at one factor over a long period of time and generally disregard all others. Examples include negative lifestyle factors like smoking and eating poorly. These factors tend to bring results down. These are what we call confounding variables. 

P-hacking is the way statistical results are interpreted in a biased manner. So if a company is doing a study for their product they will interpret these results in a favorable manner. Remember statistics is not an exact science. We look for trends in pools of data. The only way to get the best results is to have larger pools of participants which gets more and more difficult as more and more participants are hard to manage. 

Here are some examples of acupuncture observational studies: 

Shih et al., is a retrospective cohort study comparing stroke recurrence rate in ischemic stroke patients with and without acupuncture treatment (Shi, 2015). This particular study followed 30,058 patients, ages 30 and over, newly diagnosed cases of ischemic stroke between 2000-2004. At the end of the 10 year period the stroke recurrence was 71.4/1000 person-years for the group without acupuncture and 69.9/1000 person-years with acupuncture (P<0.001). Acupuncture treatment was associated with reduced risk of stroke recurrence (Hazard Ratio(HR) 0.88; 95% Confidence Interval(CI) 0.84–0.91) using the Cox proportional hazard model. Furthermore, groups were broken down to:

• Acupuncture alone HR 0.50 (95% CI 0.43–0.57), 
• Acupuncture with medication HR 0.39 (95% CI 0.35–0.43)
• No acupuncture, medication only HR 0.42 ( 95% CI 0.38–0.46). 

The Cox model is a method for investigating the effect of several variables upon the time a specified event takes to happen according to statsdirect.com. Comorbidities including hypertension, diabetes, and hyperlipidemia were identified as the keystroke risk factors that might contribute to stroke recurrence and compound the effectiveness of acupuncture treatment. Effects of medications for stroke prevention including antiplatelet agents, anticoagulants, and lipid-lowering agents on stroke recurrence were also assessed (Wang, 2016). 

The conclusion was that acupuncture with medication had the lowest rate of recurrence of stroke and that it was worth investigating further with well designed randomized controlled clinical trials with sham/blinding controls. 

“Electroacupuncture for reproductive hormone levels in patients with diminished ovarian reserve: a prospective observational study” is a prospective observational case series research study. This study took 21 women with diminished ovarian reserve (DOR) and looked at the effects of electric acupuncture (EA) because studies on DOR are lacking. 

21 women were given EA for 12 weeks. The dosage was five times a week for four weeks and three times a week for eight weeks. The primary outcome was the change from baseline in the mean FSH level at week 12. Secondary outcomes included changes in FSH/LH ratio, mean LH, E2 and FSH levels, and a four-point symptom scale (measuring irritability and depression) at weeks 4, 8, 12 and 24 . Patients scored themselves according to their own feelings (Wang, 2016.)

• Mean FSH levels fell over the course of the study from 19.33±9.47 mIU/mL at baseline to 10.58±6.34 mIU/mL at week 12 and 11.25±6.68 mIU/mL at week 24
• LH levels decreased more gradually from 6.35±3.40 mIU/mL at baseline to 4.55±3.47 mIU/mL at week 12 (p=0.062) and 4.33±2.04 mIU/mL at week 24 (p=0.004)
• FSH/LH ratio was significantly reduced compared with baseline (3.43±0.32) at week 24 (2.70±0.42, p=0.017) but not at week 12 (3.26±2.84, p=0.274)
• E2 levels were significantly higher than at baseline (39.16±7.47) at week 12 (96.73±30.72, p=0.016) but not at week 24 (63.16±92.50 mIU/mL, p=0.052).
• Participants reported a subjective increase in the volume of menstrual blood loss at 12 weeks and 24 weeks
• total score and irritability subscores, significant differences were shown at weeks 12 and 24 compared with baseline. No difference was found for depression (Wang, 2016)

Concluding that EA may decrease FSH, LH, FSH/LH ratio, increase E2 and improve emotional symptoms, and that the effects last for up to 3 months without serious side effects. 

About the author 

Michael D. Beys L. Ac., D.A.C.M. is a Doctor of Acupuncture and Herbal Medicine. His training consisted of over 3000 hours in the study of acupuncture and herbal medicine and has over 20 years of clinical experience. He was supervising acupuncturist at RUMC’s substance abuse Detox Center, South Beach Psychiatric Rehab facility and treating acupuncture physician at Sunrise Detox. 

He is also fluent in Greek, and Spanish, and proficient in Mandarin, Arabic, and Italian. Currently, his practice focuses on fertility and women’s health, pain management, and substance abuse mental health. 

Chun-Chuan, S., Chien-Chang, L., Mao-Feng, S., Yi-Chang, S., Chi-Pang, W., Morisky, D., & Fung-Chang, S. (2015, October 2). A Retrospective Cohort Study Comparing Stroke Recurrence Rate in Ischemic Stroke Patients With and Without Acupuncture Treatment. Wolter Kluwer’s Medicine, 94(39). doi: 10.1097/MD.0000000000001572 

Cox (Proportional Hazards) Regression (n.d.). In statsdirect.com. Retrieved February 12, 2018, from https://www.statsdirect.com/help/survival_analysis/cox_regression.htm 

Wang Y, Li Y, Chen R, et al 

Electroacupuncture for reproductive hormone levels in patients with diminished ovarian reserve: a prospective observational study 

Acupuncture in Medicine 2016;34:386-391.