Friday, 29 October 2010

Lies, Damned Lies and Headlines (or why acupuncture is so safe)

I nearly leaped out of my chair in alarm the other day when I read a headline in The Guardian 'Dozens killed by incorrectly placed acupuncture needles'. How on earth, I wondered, had that happened, since I know how scrupulously safe professional acupuncturists are?

It is also completely at odds with the York Acupuncture Safety Survey, published in the British Medical Journal in 2001, carried out by Hugh McPherson of York University, which looked at nearly 35,000 treatments carried out by professional acupuncturists in the UK. The survey did not uncover a single serious adverse event (ie, something requiring hospital treatment) Even minor adverse reactions were rare - just 1.3 per 1000 treatments - most commonly fainting or nausea. To me, this seems pretty damn safe.

On reading the Guardian article, I quickly found out that the screeching headline was entirely misleading, and designed to create disproportionate alarm.

The article was based on a recent paper by Edzard Ernst, professor of complementary medicine at the University of Exeter, entitled Deaths after acupuncture: A systematic review. Ernst's paper indicates that worldwide, since 1946, there have been 86 deaths in which acupuncture was the probable cause, the vast majority of which were in China or Japan.

The causes of death Ernst lists include punctured lungs, or complications from the use of unsterilised needles. He says this shows the importance of adequate training for all acupuncturists.

Professional acupuncturists in the UK use only sterile single-use needles

So let's put this in perspective.
1. Throughout the whole world, there have been only 86 reported deaths from acupuncture in the last 64 years, though I would guess there will have been millions of acupuncture treatments over the same period.
2. Of that tiny number of deaths, most took place in China or Japan. China, certainly, during much of this period could not be classed as a developed nation, so the conditions of treatment or the provenance of the practitioners in those tiny number of fatalities is a matter of legitimate scepticism.
3. Nobody, but nobody makes use of re-usable needles anymore. They are all single-use sterile needles that come in blister packs from proper suppliers. You couldn't get the other sort if you tried, and who would? Seriously.
4. Needle training 101 for acupuncturists is to only needle at a shallow angle over the lungs, and to avoid needling completely if people are very thin, or there's the slightest risk. We take the safety of patients very very seriously.
5. Pretty well anywhere you go in the developed world, professional acupuncturists will belong to reputable professional organisations, such as the British Acupuncture Council, with strict requirements for training and professional skill. I myself had to study for three years and spend large amounts of time in clinic under supervision before I was qualified to practice. I still have to maintain continuous professional development to keep my skills and knowledge up-to-date. Acupuncturists are not dangerous cranks, they are trained committed professionals.

So ... if I look at the reality of professional standards in the UK and elsewhere, together with the weighty support of evidence for safety in McPherson's study, and set it against the rather contrived sense of alarm running through the Guardian article about Ernst's paper, and make a considered judgement about the safety of acupuncture, I know what conclusion I would make.

Acupuncture is demonstrably safe.

I hope you will agree.