Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial

I am sure this research project entailed an enormous ammount of hard
work in planning, co-ordination and analysis. It ticks presumably all the
right boxes for ethical approval. informed consent and statistical
analysis. It concludes that accupuncture leads to persisting clinically
relevant benefits, by randomising patients to standard care or this plus
twelve additional accupuncture sessions. Those in the accupuncture group
received far more proffessional contact from caring people. Throughout the
history of clinical trials such contact has been shown to improve
outcomes. Patients love to be cared for and respond appropiately. The
authors in their section on "Limitations" mention there is no "sham
accupunture" group and dismiss possibilities of bias and the relevance of
a placebo effect. Indeed they say "in everyday practice patients benefit
from placebo", as if to justify the possibility that this may have
contributed to the effect. In the "what is already known section" of the
article it says that "The methodoligical quality of previous studies has
been questioned". Surely the same must be said of this study.
If a pharmaceutical medicine had been studied in this way there would be
an outburst of indignation in relation to the conclusions. I am not sure
why we have these double standards.
I have no doubt accupuncture is beneficial for pain, and use it for myself
and my patients. I am however not sure that this article takes the
scientific rationale for its use any further forward.

Competing interests:
I am a pharmaceutical physician whom has received an income from the pharmaceutical industry in the past and continue to consult for the industry