Clinical Acupuncture and Oriental Medicine最新文献

Among Western students and clinicians of Chinese medicine, the concept of peer review has become associated with specific aspects of academic and scientific writing that have immediate and obvious political and commercial consequences. For example, peer review is often discussed as if it were equivalent to a demand for randomized controlled clinical trials (RCT) or a specific approach to transparency in translation. While these are important issues, peer review is not a single specific practice but a philosophy indispensable to the traditional Western commitment to free expression. It is the critical means by which validity is assessed over time. It is necessary for the formation of consensus within any field. Peer access to information is also essential to recognizing the right of readers to know the sources and methods by which claims of value are made. Since a fundamental set of information needed for effective peer review can be described, the absence of uniform labels and formats is a significant lack that the Council of Oriental Medical Publishers (COMP) should address.

In recent years, many systematic reviews of the clinical efficacy of acupuncture have been conducted. Almost every review found major problems with the quality of the clinical trials, making it difficult to draw clear conclusions about efficacy. The present paper explores a number of important issues involved in the design and conduct of systematic reviews of acupuncture. Examples are pointed out of mistakes in inclusion-exclusion criteria and problems with judgements about adequacy of test treatment in some reviews. More importantly, problems are identified with the criteria by which study quality is scored, especially with the Jadad summary scale, that appear to bias against finding acupuncture to be effective. Examples are also identified where the conclusions of systematic reviews appear to have been misstated by others summarizing findings of those reviews, thereby undermining the conclusions of those broader reviews. These findings suggest that the methodologies of systematic reviews of acupuncture need to be improved and that many systematic reviews need to be redone using improved methods.

In the development of Chinese medicine in the West, emphasis has been placed on immediately utilizable clinical information to the detriment of an accurate representation of East Asian practice and the tradition of experience in which it is based. The body of English-language literature that has developed does include genuine attempts to present the East Asian tradition accurately. Nevertheless, it also includes contributions by people who have little or no linguistic access to East Asian experience in the healing contained in East Asian-language sources and who have had only brief contact with East Asian clinicians. It further includes versions of Chinese medicine that are adapted to perceived Western needs, often without substantiation in either scientific terms or in the East Asian medical tradition. We have a body of literature that is not only composed at least in part by a narrow, often overly personalized view of Chinese medicine. But what is more, this body of literature is blighted by highly variable terminology that often hampers the accurate transmission of Chinese medical concepts to Westerners, and that is not sufficiently unified to ensure unequivocal communication. In short, the development of Chinese medicine in the West has suffered by failure to accord due importance to gaining direct access to the East Asian tradition, and at the core of every aspect of this problem is the failure to meet the challenges posed by language. This failure can only be fully remedied by encouraging students and practitioners to learn Chinese or other East Asian languages, by promoting translation of primary literature, and by nurturing a process of term standardization. The present paper outlines these proposals, and the four papers that follow it, whose titles are listed below, expound them in greater detail. The last two papers will appear in the next issue of the Journal as ‘Language, the Neglected Key. Part 2’:The Transmission of Chinese Medicine: Chop Suey or the Real Thing?, Translation of Chinese Medical Terms: Not Just a Matter of Words, Learning Chinese: Feasibility, Desirability, and Resistance, Chinese Medical Dictionaries: A Guarantee for Better Quality Literature.

Highlights of the recent conference of the Society for Acupuncture Research are presented. The diversity of presentations, from physiological correlates of acupuncture to clinical trials of acupuncture and herbs, to considerations of acupuncture effects on bioelectromagnetic fields, reflects the rapid development of research and critical thinking in the field of acupuncture and Oriental medicine.