Military Spending for VERY questionable medical procedures

Has anyone else seen this article about so-called “Battlefield Acupuncture”?

Since when does this woo qualify as a “medical procedure”? Is there a map of the major nerves that run from the ear to the upper back or shoulders available out there that someone could point out to me?

  1. The U.S.A.F has designated acupuncturists?!? What job classification number would that be?
  2. Colonel Niemtzow developed this medical procedure on his own, and he has trained hundreds of his counterparts. I wonder if any of his counterparts have done any independent studies.

Interesting, I had no idea this was taking place.

I used to view stuff like chiropractors and acupuncture practicioners with a jaundiced eye, but I suppose if the patients are getting a genuine benefit from it, what’s the harm?

Human wiring is so fucked up (try pressing the reflexology pressure points on a friend’s foot and see if she reacts in the “correct” place) I don’t have any problem with anything that appears to work.

Like placebos? Would you be okay with taxpayer money going to ‘research’ and distribution of expensive placebos for soldiers?

I have no problem with idiots poking needles into each other based on their idiot beliefs, but spending taxpayer money to legitimize the practice (and perhaps inflicting it on unwitting soldiers) is crossing the line.

What’s next? “Battlefield Voodoo”?

shrug Whatever works to make killing your fellow man easier.

The army also employs chaplains, and pays them with taxpayer money. Do you object to that as well ? I have no problem with idiots feeding each other wine and cookies based on their idiot beliefs, but…:wink:

What job classification is medical corpsman in the Air Force?

I have no issue with this.

Comparing chaplains to “battlefield acupuncture” is a false equivalence. Chaplains have more responsibilities than just fulfilling the troops’ spiritual needs.

Here’s where I have trouble accepting this.

Fifteen percent of patients don’t respond to acupuncture. That, to me, isn’t a good enough result to rely on it in a “battlefield” situation. It may work well on people for whom this is a complementary treatment, but I’d hate to be the poor schmuck in the field for whom this may be the only treatment.

Here’s the rest of the rub:

Based on my own experiences in the military, I’ve got a problem with this. I can see this being misused by someone with little to no actual medical experience making the determination to withhold medication.

I’ve also got news for the good doctor. Pain also clouds judgment, probably more so than appropriate pain medication. One of the reasons military docs are so fond of handing out ibuprofen and other NSAIDS is because they tend not to cause drowsiness and sedation like narcotic pain meds do. It sounds like he’s fishing for justification for his program.

I could see funding this if it were properly researched and if proper guidelines for use were to be developed. But it’s not and it sounds like these people are encouraging any yo-yo with a pulse to use it. That’s not good medicine.

Robin

I’d have an issue with it if I was in Iraq and had just been shot and the medical corpsman was sticking needles in my ear instead of giving me real medical help.

Accupunture works- well, sometimes and we don’t fully understand why. The Traditional Chinese explanation of how it works is hooey.

According to traditional Chinese medical theory, these acupuncture points lie along meridians along which qi, the vital energy, flows. There is no known anatomical or histological basis for the existence of acupuncture points or meridians.[5][6] Modern acupuncture texts present them as ideas that are useful in clinical practice.[7][8][9] According to the NIH consensus statement on acupuncture, these traditional Chinese medical concepts "are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture

*Evidence-based medicine

There is scientific agreement that an evidence-based medicine (EBM) framework should be used to assess health outcomes and that systematic reviews with strict protocols are essential. Organizations such as the Cochrane Collaboration and Bandolier publish such reviews. In practice, EBM is “about integrating individual clinical expertise and the best external evidence” and thus does not demand that doctors ignore research outside its “top-tier” criteria.[53]

The development of the evidence base for acupuncture was summarized in a review by researcher Edzard Ernst and colleagues in 2007. They compared systematic reviews conducted (with similar methodology) in 2000 and 2005:

The effectiveness of acupuncture remains a controversial issue. ... The results indicate that the evidence base has increased for 13 of the 26 conditions included in this comparison. For 7 indications it has become more positive (i.e. favoring acupuncture) and for 6 it had changed in the opposite direction. It is concluded, that acupuncture research is active. The emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions.[11]

For low back pain, a Cochrane review (2005) stated:

Thirty-five RCTs covering 2861 patients were included in this systematic review. There is insufficient evidence to make any recommendations about acupunc*ture or dry-needling for acute low-back pain. For chronic low-back pain, results show that acupuncture is more effective for pain relief than no treatment or sham treatment, in measurements taken up to three months. The results also show that for chronic low-back pain, acupuncture is more effective for improving function than no treatment, in the short-term. Acupuncture is not more effective than other conventional and "alternative" treatments. When acupuncture is added to other conventional therapies, it relieves pain and improves function better than the conventional therapies alone. However, effects are only small. Dry-needling appears to be a useful adjunct to other therapies for chronic low-back pain.[54]

A 2008 review suggest that combining acupuncture with conventional infertility treatments such as IVF significantly improves the success rates of such medical interventions.[55]

A review by Manheimer et al. in Annals of Internal Medicine (2005) reached conclusions similar to Cochrane’s review on low back pain.[56] A review for the American Pain Society/American College of Physicians found fair evidence that acupuncture is effective for chronic low back pain.[57]

For nausea[58] and vomiting: The Cochrane review (Lee and Done, 2006) on the use of the P6 acupoint for the reduction of post-operative nausea and vomiting concluded that the use of P6 acupoint stimulation can reduce the risk of postoperative nausea and vomiting with minimal side effects, albeit with efficacy less than or equal to prophylactic (i.e., preventative) treatment with antiemetic drugs.[59][60] Cochrane also stated: “Electroacupuncture is effective for first day vomiting after chemotherapy, but trials considering modern antivomiting drugs are needed.”[61]

A 2007 Cochrane Review for the use of acupuncture for neck pain stated:

There is moderate evidence that acupuncture relieves pain better than some sham treatments, measured at the end of the treatment. There is moderate evidence that those who received acupuncture reported less pain at short term follow-up than those on a waiting list. There is also moderate evidence that acupuncture is more effective than inactive treatments for relieving pain post-treatment and this is maintained at short-term follow-up.[62]

For headache, Cochrane concluded (2006) that “(o)verall, the existing evidence supports the value of acupuncture for the treatment of idiopathic headaches. However, the quality and amount of evidence are not fully convincing. There is an urgent need for well-planned, large-scale studies to assess the effectiveness and cost-effectiveness of acupuncture under real-life conditions.”[63]

For osteoarthritis, reviews since 2006 show a trivial difference between sham and true acupuncture.[51][64]

For fibromyalgia, a systematic review of the best 5 randomized controlled trials available found mixed results.[65] Three positive studies, all using electro-acupuncture, found short term benefits. The methodological quality of the 5 trials was mixed and frequently low.*

So, accupuncture relieves pain- sometimes.

I was surprised when I went through IVF that my doctor referred me (and all his infertility pts) to an accupuncturist. Allegedly the accupuncture helps stimulate the ovaries…they even had clinical data to support their claims. Prior to that, I always assumed that MDs thought accupuncture was a crock.

No one in the article was advocating this be the first pain control treatment. Despite the name given to the process - battlefield accupuncture - everything in the article about actual use was with patients who’d already been evacuated to Germany and were not getting relief from conventional treatment.

The bit about pain relief prior to a mission was speculation on future usage.

All of the people mentioned in the article as using the technique were trained on the process.

“I was surprised when I went through IVF that my doctor referred me (and all his infertility pts) to an accupuncturist. Allegedly the accupuncture helps stimulate the ovaries…they even had clinical data to support their claims.”

A study came out recently showing it had no effect at all.

Until you see a mountain of evidence supporting it, treat it as the usual pseudoscience hooey. Infertility is a classic area for this kind of malarkey, Ive lost count of how many alternative medicine treatments we were advised to have.

Treatments that work dont need ‘emerging evidence’ they just have evidence.

Otara

It was actually the “battlefield voodoo” bit that made me think of Army chaplains :).

Cite ? Not that I doubt you in any way - Wikipedia has merely failed to provide me with a clear picture of what it is a chaplain actually does, besides the obvious Sunday indoor pic-nic and the equally obvious pre-battle pep talk and the last voodoo spells for the dead/dying.

(but that may turn into a massive hijack, now that I think about it. Feel free to leave me to my ignorance.)

Yeah I neglected to mention that it didn’t work. But in fairness I only did one cycle with acupuncture-out of many that failed -so obviously this is anecdotal. But when your clock is ticking and you don’t have the luxury of waiting around for it to get thru the fda, and they say it “might” help,…you’ll try it. But for the most part I thoroughly agree with your logic.

Out of curiosity, several episodes of MASH* depict (no doubt highly fictionalized) advances in surgical technique improvised by the characters. How much of what we consider modern emergency medicine came about from military necessity, including some practices that might at first to appear “questionable” ?

There is no truly credible evidence that acupuncture does a damn thing except for a possible placebo effect. Studies have found that it doesn’t matter where you stick the needles or what you do with them: a certain sign of crackpottery.

The National Council Against Health Fraud has concluded:

QuackWatch has this to say:

I’m damn angry that my tax dollars are being wasted on fairytale pseudo-medicine!

And yet there is a mountain of evidence, as DrDeth so kindly pointed out. Why treat it as “hooey”, then?

Au contrare, there are studies which demonstrate the effectiveness of traditional Chinese acupunture over a control group which was randomly pricked with needles:
http://nccam.nih.gov/news/newsletter/2005_winter/acupuncture.htm

Was anyone else expecting “Battlefield Acupuncture” to be a satirical euphemism for shooting people?

Chaplains also provide counseling and, indeed, may be the only source of psychological support under some circumstances.

Robin

Science based medicine covers this

ETA: and the followup ain’t pretty