Acupuncture Research: Strategies for Establishing an Evidence Base

Acupuncture Research: Strategies for Establishing an Evidence Base

Hugh Macpherson

This is the first book to set out a full range of research strategies for evaluating the clinical practice of acupuncture. Leading acupuncturists and researchers with international reputations share their expertise. They illustrate their descriptions with practical examples of what has worked and what has not. It outlines many of the key challenges in the field. These challenges relate to the nature of acupuncture and the gap between current research evidence and the actual experiences of acupuncturists in the field.

By focusing the chapters on key research questions, rather than methods, the book has a user-friendly feel. Each chapter is easily accessible with brief explanations of research designs as well as vignettes of relevant past research. The book is based on a deep understanding of acupuncture, with its inherent complexity in practice, whether based on traditional principles or more modern concepts. By incorporating a more sophisticated understanding of the field, this book details a range of strategies aiming to develop the evidence base with the utmost rigour. It is the first book on acupuncture research to take this unique view, integrating the very best of evidence-based medicine with a genuine sensitivity to the discipline of acupuncture, from its traditional and holistic roots to its more modern interpretations.

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JCM Review

ACUPUNCTURE RESEARCH : STRATEGIES FOR ESTABLISHING AN EVIDENCE BASE
by Hugh MacPherson, Richard Hammerschlag, George Lewith & Rosa Schnyer, Churchill Livingstone, softback, 288 pages

With this book MacPherson, Hammerschlag, Lewith, Schnyer and co‑authors have produced a comprehensive synthesis of the current state of acupuncture research that will be a valuable reference for existing researchers as well as offering a clear overview for practitioners and others wishing to find out about or embark on research in acupuncture. It becomes clear from the outset that the contributors have made a real effort to elicit the key research themes and concepts that have developed over the years, and to thread these together to present the bigger picture. Initial chapters were written by small groups of authors and then discussed and debated in a workshop amongst all the participants before being re‑written to incorporate these discussions and feedback. This process gives the book a coherence that is not often found in other works that present a collection of chapters by different authors, and the advantage gained by pooling together the collective experience of the different authors in this way is one of its main strengths. Its focus is on strategies that bridge the gap between current evidence and the actual experiences of acupuncturists. The authors seek to find a balance between the simplification of problems required to make them amenable to modern methods of research whilst keeping them representative of the real practice of acupuncture. Birch and Lewith present a chapter giving a background to acupuncture research, and the potential for philosophical mismatches between Eastern and Western paradigms, such as when modern reductionist methods are not appropriate for the evaluation of a holistic system of medicine. They also provide perspectives for understanding the complexity of acupuncture research in the face of a huge diversity of styles of clinical practice. Following chapters make the case for patient‑based research strategies, emphasising the role of patient beliefs and perceptions about acupuncture, how to measure treatment outcomes from the patient’s perspective, and how to identify and quantify levels of risk associated with acupuncture. Throughout the discussion, the authors present and compare a broad range of qualitative and quantitative methods, and give numerous examples from the literature to illustrate their differing strengths, and how these multiple perspectives can be integrated to produce a holistic research programme. Three chapters are devoted to evaluating the effectiveness of acupuncture, but the authors go far beyond their very clear exposition of RCTs and associated sources of bias, control procedures and assessment of efficacy. They make a strong case for the development of research feeding continuously through all levels from the lone acupuncturist making case reports on treatment effects observed in the clinic to groups of scientists engaged in rigorous clinical trials. They argue that acupuncture provides a unique arena to develop more global approaches to quantitative research, seeking to understand and embrace those elements which conventional research often seeks to screen out, and they give a good account of different types of trials that have been developed as a result of this. Other chapters explore current thinking on biological correlates and physiological mechanisms of acupuncture, how to bring evidence together in systematic reviews and how acupuncturists can become more involved in research and help to foster the links between research and clinical practice. A final chapter by Lewith speculates on the future directions of acupuncture research. Each chapter contains a comprehensive list of references, and where appropriate contains links to useful online resources. The book will certainly be a valuable reference for researchers who are looking for a current overview of the state of acupuncture research. It will perhaps be even more valuable for teachers, students and practitioners of acupuncture, as it provides a clear roadmap to the many different techniques and perspectives necessary to take an idea born in the clinic and develop it into a coherent research theme that will be of value to the profession as a whole.

Mike Cassidy

Contents

Glossary of research terminology
Chapter 1 Introduction: acupuncture and the emerging evidence mosaic, Hugh MacPherson, Kate Thomas
Chapter 2 Acupuncture research: the story so far, Stephen Birch, George Lewith
Chapter 3 Patient patterns of use and experience of acupuncture, Claire M. Cassidy, Kate Thomas
Chapter 4 The safety of acupuncture, Hugh MacPherson, Adrian White, Alan Bensoussan
Chapter 5 Measuring patient-centred outcomes, Charlotte Paterson, Rosa N. Schnyer
Chapter 6 Exploring treatment effects: studies without control groups, Adrian White, Peter Wayne, Hugh MacPherson
Chapter 7 Comparing treatment effects of acupuncture and other types of healthcare, Karen Sherman, Klaus Linde, Adrian White
Chapter 8 Investigating the components of acupuncture treatment, Peter White, Klaus Linde, Rosa N. Schnyer
Chapter 9 Acupuncture practice as the foundation for clinical evaluation, Rosa N. Schnyer, Stephen Birch, Hugh MacPherson
Chapter 10 Physiological dynamics of acupuncture: correlations and mechanisms, Richard Hammerschlag, Helene M. Langevin, Lixing Lao,George Lewith
Chapter 11 Evidence overviews: the role of systematic reviews and meta-analyses, Klaus Linde, Richard Hammerschlag, Lixing Lao
Chapter 12 Engaging acupuncturists in research ?some practical guidelines, Peter Wayne, Karen Sherman, Mark Bovey
Chapter 13 Future strategies for acupuncture research, George Lewith
Index

Overview

AuthorHugh Macpherson
Publication Date29/03/1976
PublisherChurchill Livingstone
Number Of Pages288
Book FormatSoftback
ISBN978-0443100291

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