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To the Editor: Dr Miller and colleagues¹ categorized the acupuncture study by Smith et al² as "negative" because the difference between sham and active acupuncture treatments was not statistically significant. Lewith and Vincent,³ however, argued that sham acupuncture is a weak active treatment, as suggested in this case by the lag in antinausea effect between the sham and the 2 active treatments. Women receiving the highest dose of acupuncture (ie, the traditional acupuncture group) reported significantly less nausea throughout the trial. Women receiving the next highest dose of acupuncture reported significantly less nausea from the second week in the trial, while women receiving the lowest dose of acupuncture (ie, sham acupuncture) reported significantly less nausea from the third week in the trial.

Although the authors could have cited high-quality RCTs with positive results,⁴ they reported that most trials have negative results. Linde and Willich⁵ point out that different systematic reviews . . . [Full Text of this Article]

Paul J. Millea, MD, MA
pmillea@mail.mcw.edu
Department of Family and Community Medicine
Medical College of Wisconsin
Milwaukee

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