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1. Elden H. et. al. Effects of acupuncture and stabilizing exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised single blind controlled trial. British Medical Journal, 2005 April 2; 330(7494): 761.The study compares the efficiency of standard treatment plus acupuncture versus standard treatment alone and standard treatment plus exercises for this particular type of chronic pain. The authors concluded that in this study both acupuncture and stabilising exercises proved to be efficient complements to standard treatment, and that acupuncture proved to be superior to stabilising exercises.2. Manheimer E. et. al. Meta-analysis: acupuncture for low back pain. Annals of Internal Medicine 2005 Apr 19;142(8):651-63.The authors analyzed 33 randomized, controlled trials that studied the effects of the acupuncture for chronic pain. The studies varied in types of pain, styles of acupuncture, and control groups used, but a primary outcome in all studies was the short-term relief of chronic pain. The meta-analyses showed that acupuncture is significantly more effective than sham treatment and effectively relieves chronic low back pain; however, no evidence was found that acupuncture is more effective than other active therapies.3. Acupuncture Relieves Pain and Improves Function in Knee Osteoarthritis. NIH News Release, available online December 20, 2004, www.nih.gov/news/pr/dec2004/nccam-20.htm.National Institutes of Health, an agency of the U.S. Department of Health and Human Services, released a news report summarizes the findings of several studies, including a landmark study by the National Center for Complementary and Alternative Medicine (NCCAM) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the longest and largest randomized, controlled phase III clinical trial of acupuncture ever conducted. NIH endorses applying stringent research methods to ancient practices like acupuncture. Overall, those who received acupuncture had a 40 percent decrease in pain and a nearly 40 percent improvement in function compared to baseline assessments. Thus, it is concluded that acupuncture is an effective complement to conventional treatments and an invaluable part of a multidisciplinary approach.4. Leung, Albert Y.  Effect Of Acupuncture On The Quality Of Life In Patients With Chronic Pain: A Prospective Outcome Measure. Medical Acupuncture. 2004; 2(14):45-49.To study assessed benefit of acupunctures on the quality of life and pain relief in patients with chronic pain. Inclusion of various types of chronic pain (low back pain, shoulder pain and chronic neck pain) as well as various outcome measures (pain relief, sleep improvement, improvement in sense of well-being, reduction of analgesics) set this study apart from most other studies.5. Hammerschlag R. Methodological and ethical issues in clinical trials of acupuncture. Journal of Alternative Medicine, 1998; 4:159-171.Author discusses the broad questions pertaining to acupuncture: Is there sufficient evidence that acupuncture outperforms control treatment? Does acupuncture perform at least as well as biomedical care? Is acupuncture an effective adjunct to standard care? To answer these questions, the four major research designs are reviewed and discussed: 1) Acupuncture compared with no treatment (wait-list controls); 2) Acupuncture compared with control treatment, either placebo or sham (invasive needling); 3) Acupuncture compared with biomedical standard care (medication, medical device, or physiotherapy); 4) Acupuncture plus standard care compared with standard care alone. 6. Shang, Charles. The Mechanism of Acupuncture – Beyond Neurohumoral Theory. Acupumcture.com, available online May 2, 2005, www.acupuncture.com/education/theory/mechanismacu.htmBroad and comprehensive overview explaining the mechanisms of acupuncture. Several neurophysiological theories and alternative explanations are provided and discussed.8. Linde K. et. al. Acupuncture for patients with migraine: a randomized controlled trial. The Journal of American Medical Association. 2005 May 4; 293(17):2118-25.I selected this article to illustrate how the author uses the descriptive statistical measures we have learned about in this module. The article provides statistical data and its interpretation for the purpose of this study (effectiveness of acupuncture for the prevention and treatment of migraines). The data supports the autho’s conclusion that acupuncture’s effect is purely psychological, that is the sham treatment showed the same effectiveness as the real acupuncture.The study involved three groups for randomized and controlled trial. It involved 302 patients (88% women), with  mean age of 43 years (standard deviation 11 years), suffering from migraine headaches. The three groups had different interventions: acupuncture, sham acupuncture, and waiting list control. Acupuncture and sham acupuncture consisted of 12 sessions per patient over 8 weeks. Patients completed headache diaries from 4 weeks before to 12 weeks after randomization. Main outcome measure was the difference in headache days of moderate to severe intensity between.The authors report the following results: mean number (with the corresponding standard deviation) of headache days decreased by 2.2 (SD=2.7) days from a baseline of 5.2 (SD=2.5) days in the acupuncture group compared with a decrease to 2.3 (SD=2.6) days from a baseline of 5.0 (SD=2.4) days in the sham acupuncture group, and by 0.6 (SD=2.0) days from a baseline of 5.4 (SD=3.0) days in the waiting list group. From these results, we can see that there is no difference was detected between the acupuncture and the sham acupuncture groups, while there was a difference between the acupuncture group compared with the waiting list group. Since the standard deviation values are very close for all three mean outcomes, the author concludes that the results are statistically significant (null hypothesis for the sham vs. acupuncture, null hypothesis rejected for the acupuncture vs. no treatment).The author further uses the data distribution ranges and the means of inferential statistics (confidence intervals, P-values as actual significance level) to evaluate the statistical significance of the reported results. The smaller the p-value, the smaller is the probability that the observed result occurred due to chance (which is a sampling error). For the first hypothesis (sham vs. acupuncture) these results were calculated as 0.0 days, 95% confidence interval, -0.7 to 0.7 days and P = .96 respectively, which indicates that there is no statistical difference between the outcomes.  Comparing to the waiting list group (second hypothesis), though, the respective numbers were 1.4 days; 95% confidence interval; 0.8-2.1 days and P<.001, which shows that P-value (actual significance level) is significantly less than the chosen alpha level and thus the null analysis is rejected.The above results allowed the authors to conclude that in this study acupuncture was no more effective than sham acupuncture in reducing migraine headaches, although both interventions were more effective than a waiting list control. 

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