Intended for healthcare professionals

Rapid response to:

Reviews TV

Alternative Medicine

BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7535.241 (Published 26 January 2006) Cite this as: BMJ 2006;332:241

Rapid Response:

Good in (a few) parts

After watching the first programme in this series, I wondered whether
if I were developing a drug, and went to the regulatory authority with one
trial that showed it worked in one indication, and 20 which either showed
it didn't, or were flawed and showed nothing, would I get a licence? But
that seemed to be Professor Sykes' approach. Not only that, but viewers
were asked to believe that the very limited data presented on the
programme somehow `proved' (the language used by Professor Sykes) that
acupuncture works generally. Why does the BBC persist in this belief that
science has to be dumbed down for the masses?

While respecting Professor Sykes' eminence within her field, it was a
mistake to put a physicist in the anchor position for this series. She
could not for example spot what was going on with the open heart surgery.
Regional anaesthesia is regularly used (I am advised) in young patients
having short procedures. No need to ventilate - we saw the bypass machine.
The whole thing could have been done just with sedation and `numbing the
chest', which could easily have been a nerve block. The needles were a red
herring.

When the subject of migraine was introduced, I immediately expected
to hear about the large study by Linde et al (1), which was negative. But
no, we were treated to a study which was positive. Much the same can be
said of the osteoarthritis story, as another study has shown far less
clear-cut results [2]. This was puzzling, in view of the BBC's known
obsession with `balance'.

How extraordinary to see clinical research actually being planned and
conducted on our TV screens! But the MRI study protocol details were
pitifully brief and unclear, and it seems the investigators have published
their findings to the lay media without peer review or submission to a
journal. Is this good scientific practice? Another MRI study with
acupuncture shows little consistency with their findings, with different
brain regions showing responses [3]. It's all a world away from drugs, for
which we can identify a specific receptor and get quantitative data on
binding, agonist/antagonist effects etc - and reproducibility between
studies.

Kathy Sykes's
use of the word `amazing' was unjustified, when as it turns out, there was
nothing amazing about the open heart surgery. She missed an opportunity to
get across to the lay public what science and evidence really are. She
could easily have emphasised the limited generalisability of the results
presented, but instead gushed with enthusiasm. But then she is not a
clinical scientist, and hasn't seen drug development stop when the
evidence just wasn't strong enough.

Les Rose, BSc CBiol MIBiol FICR MAPM

References

1. Linde K, Streng A, Jurgens S, Hoppe A, Brinkhaus B, Witt C,
Wagenpfeil S, Pfaffenrath V, Hammes MG, Weidenhammer W, Willich SN,
Melchart D. Acupuncture for patients with migraine: a randomized
controlled trial.
JAMA. 2005 May 4;293(17):2118-25.

2. Witt C, Brinkhaus B, Jena S, Linde K, Streng A, Wagenpfeil S,
Hummelsberger J, Walther HU, Melchart D, Willich SN Acupuncture in
patients with osteoarthritis of the knee: a randomised trial.
Lancet. 2005 Jul 9-15;366(9480):136-43.

3. Fang JL, Krings T, Weidemann J, Meister IG, Thron A. Functional
MRI in healthy subjects during acupuncture: different effects of needle
rotation in real and false acupoints. Neuroradiology. 2004 May;46(5):359-
62. Epub 2004 Apr 22.

Competing interests:
None declared

Competing interests: No competing interests

27 January 2006
Leslie B Rose
Director and consultant
Pharmavision Consulting Ltd, Salisbury, SP2 8NJ, UK