Worthless and Unethical

Worthless and Unethical

I have this understanding of reality and infectious diseases. Many, but not all, of the illnesses of childhood get better without treatment. Occasionally they can have severe complications. Most cases of tonsillitis will get better with time, but occasionally they can progress to cause throat abscesses or septic thrombophlebitis of the internal jugular.  It depends on the cause of the tonsillitis, which can he bacterial or viral.  Antibiotics can shorten the course of bacterial tonsillitis and, perhaps, prevent the unusual complications.

Another understanding I have is that acupuncture is worthless nonsense that should have no efficacy against infections.

Another understanding is that it would be, to my way of thinking,  unethical to compare a useless treatment, like acupuncture, against a useful treatment, like antibiotics,  for infections. And, unless your IRB is drunk or incompetent, such a comparison should not be done on children. It is not as if they can give informed consent.

Except in China. I give you Efficacy observation of acupuncture bloodletting and penicillin on treatment of children acute tonsillitis. I do not have access to the original, only the abstract and a press release.

They enrolled

Seventy-five mild cases (who) were selected into section of mild symptoms while seventy-five severe cases were selected into section of severe symptoms.

Really. Children with severe symptoms.  IAnd randomized them to

an acupuncture bloodletting group, a penicillin group and a comprehensive group by random digital table method separately, 25 cases in each one. Qu-chi (LI 11), Hegu (LI 4), Dazhui (GV 14), Shaoshang (LU 11) and Erjian (EX 11) were selected in the acupuncture bloodletting group, intravenous injection of penicillin sodium was applied in the penicillin group and acupuncture bloodletting combined with penicillin was applied in the comprehensive group.

As best I can determine, they did not try and determine the cause of the tonsillitis and it makes the results worthless:

For the section of mild symptoms, the total effective rate was 96.0% (24/25) in the comprehensive group and 92.0% (23/25) in the acupuncture bloodletting group, which were both superior to 68. 0% (17/25) in the penicillin group (P<0.05), but no statistical significance was seen between the comprehensive group and acupuncture bloodletting group (P>0.05). For the section of severe symptoms, the total effective rate was 96.0% (24/25) in the comprehensive group, which was obviously superior to 60.0% (15/25) in the acupuncture bloodletting group (P<0.01) and 68.0% (17/25) in the penicillin group (P<0. 05), and no statistical significance was seen between the acupuncture bloodletting group and penicillin group (P>0.05).

CONCLUSION: The efficacy of acupuncture bloodletting combined with penicillin is little different from that of acupuncture bloodletting for treatment of children acute tonsillitis with mild accompanied symptoms, which were both superior to intravenous injection of penicillin sodium. For severe accompanied symptoms, the efficacy of acupuncture bloodletting combined with penicillin is obviously superior to acupuncture bloodletting and penicillin.

Most cases of tonsillitis will get better with time, and what antibiotics do is get patients better faster if due to bacteria. Without knowing if the tonsillitis was bacterial or viral, you have no way of knowing how the antibiotics might have affected the outcomes in each group.  And given the number of in each group and the p value, it is more likely statistically significant noise than a real results.

A useless study AND of questionable ethics.  

Nicely done.

Points of Interest 3.19.2014
Points of Interest 3.18.2014