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Acupuncture for 'frequent attenders' with medically unexplained symptoms.

The June issue of the BJGP has a paper, ‘Acupuncture for “frequent attenders” with medically unexplained symptoms: a randomised controlled trial (CACTUS study)’.1 It has lots of numbers, but the result is very easy to see. Just look at Figure 2 (omitted from the print version, online only).1 There is no need to wade through all the statistics; it’s perfectly obvious at a glance that acupuncture has, at best, a tiny and erratic effect on any of the outcomes that were measured. The effects, even if some are real, are obviously too small to be of any clinical significance. The paper is fascinating because it is the clearest demonstration I have ever seen that acupuncture is ineffective, and that it does not even have a worthwhile placebo effect. One may certainly criticise the lack of a sham acupuncture control group but, in a sense, that is what makes the paper fascinating. Despite the inability of the experimental design to distinguish between non-specific effects and genuine effects of acupuncture, next to no benefit was seen. The result may have been fascinating, but its significance was lost altogether on the authors. The conclusion of the paper said: