Recorded presentation

Josephine Tsakok, MBBS, MSc, Environmental Health Sciences, Mailman School of Public Health, Columbia University, 60 Haven Avenue, New York, NY 10032, 212 9287357, jt349@columbia.edu

The socio-economic cost of asthma in the US is huge. 25% of the 20 million children under 18 and 14.6 million adults have asthma; the total cost of the disease was $11.3 billion in 1998, of which half was for drugs. Many asthma patients who use albuterol, beclomethasone, and prednisolone report additional improvements in symptoms and well-being following acupuncture, without side-effects. Acupuncture may reduce asthma morbidity without the side-effects of conventional pharmacotherapy. However, a consensus on its efficacy, mechanism of action, and therapeutic administration has not been reached. Most of the many trials in the last 2-3 decades have several limitations. Sample sizes have been insufficient to detect a meaningful change, trial populations have not been standardized in terms of disease status and age, and placebo design has been idiosyncratic. A carefully designed randomized control trial may help consolidate the suggestive findings of previous trials, providing constructive data, definite in a given context, for further investigation. 240 people will be randomized to receive active treatment (local anesthetic spray before needling) or placebo (local anesthetic spray and no needling) on main asthma points for 3 weeks. A parallel group of non-human primate asthma models in a controlled environment will be treated similarly, to correct for environmental factors of asthma when compared to the human group. The main outcome measure is pulmonary function (measured before and after each acupuncture session); an improvement of 30% on pre-trial pulmonary function in the active treatment group only would lead to rejection of the null hypothesis.

Learning Objectives:

• recognize the limitations of acupuncture trials to date, particularly placebo design and randomization
• understand the steps involved in adapting the classical randomized controlled trial to a form of therapy which is non-standardized.
• discuss the significance of an animal comparison group in elucidating the effect of environmental factors.

Keywords: Asthma, Alternative Medicine/Therapies

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation