Is Our Evidence Good Enough - CTA student wins research prize

Julie Reynolds, CTA Head of Research

I attended the 12th Acupuncture Research Symposium on Saturday 6th March with a recently qualified student, Vicky Carrolan, and a recent graduate, Mita Mistry. I was also pleased to see other of our recent graduates attending. Vicky and Mita were presenting posters of their dissertation work; Vicky spoke about the feasibility and acceptability of introducing acupuncture into Cystic Fibrosis physiotherapy services, and Mita presented her work on attitudes to acupuncture in secondary care health professionals. I presented a poster on behalf of Leanne Langlois, also recently graduated, which discussed her work surveying non-acupuncture users, to see what barriers and drivers there were to their using acupuncture in the future.

We were treated to a wide range of thought provoking speakers. Volker Scheid broke down the symposium topic question (Is our Evidence Good Enough?) and asked: "who is 'our/us'?" Our current institution of CM came about not only through observation of what works clinically, but also through political, social and cultural change. He discussed his work on menopause, which was rejected by reviewers as it disagreed with text book TCM theory! He argued that there was no basic formulaic theory prior to the 1970's - instead there was talk of coherence (Li) and craftsmanship. He described Li as investigating things, wide learning, activating the Heart/Mind and practice. This was followed by a focus on Yi, often mistranslated, he argued, as 'intention'. Instead, he described Yi is signification: a focus on objectively grasping the facts - 'what is' - making patterns and investigating the literature, before coming to coherent conclusions. Our understanding of manifestations takes us into the complicated/complex realms of medicine/art as opposed to simple cause and effect.

Volker's talk made us think about the need to be clear about the gulf between diagnosis and treatment in practice, and that which is seen in effectiveness research.

Morag Heirs spoke enthusiastically about the process and benefits of systematic reviews, though as a non-acupuncturist, we felt that she missed the opportunity to stress the major flaw (from our point of view) of demanding blinding as a mainstay of the quality evaluation of clinical trials which so often leads to equivocal or false negative results in acupuncture reviews.

Claire Cassidy spoke about qualitative methods, and their use in understanding acupuncture and informing quantitative work. She focused on her fascinating study interviewing acupuncturists to find out how they prepared for and viewed their work. We also heard from Kate Thomas, who took us beautifully through the story of NICE's decision on acupuncture for back pain. Kate's research was one of the four trials that led to acupuncture's inclusion in the guidance. Interestingly, TENS and local injection were two of the interventions removed from the guidance, and she spoke about the fact that despite guidance, do we yet have implementation in practice?

And to cap off our splendid day...Vicky Carollan won the poster competition, with Mita and Leanne close behind. She received champagne and chocolates, and a free pass to next year's conference. I am extremely proud of them all and of CTA, and we're all looking forward to being involved in another thought provoking event next year...