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| The '''German Acupuncture Trials''' ('''GERAC''') were a series of ] trials set up in 2001 and published in 2006, that found no significant difference between acupuncture and sham acupuncture.<ref name="Howick2011">{{cite book|author=Jeremy H. Howick|title=The Philosophy of Evidence-based Medicine|url=http://books.google.com/books?id=O8djbHBva5IC&pg=PA92|date=23 February 2011|publisher=John Wiley & Sons|isbn=978-1-4443-4266-6|page=92}}</ref> | |||
| {{advert|date=November 2013}} | |||
| {{Medref|date=September 2013}} | |||
| ] | |||
| The '''German Acupuncture Trials''' ('''GERAC''') are a series of ] trials set up in 2001 and published in 2006, on behalf of six ].{{CN|date=November 2013}} They consist of one observational study on acupuncture side effects, and four ] (RCTs) - investigating acupuncture treatment for ], knee ], ] prophylaxis, and ]. | |||
| The observational study revealed ] occurring in 7.5% of all acupuncture patients. While the trial for tension-type headache had to be aborted, the other three RCTs had the same results: acupuncture worked as well as or even better than conventional therapy<ref>"The decision was determined by the findings of the studies that acupuncture therapy in these cases showed significant advantages compared to „standard therapy“. Whether the specific selection of acupuncture points according to Traditional Chinese Medicine (TCM) had any influence on these findings remained unclear but did not lead to a negative vote of the G-BA." As seen at: Gemeinsamer Bundesausschuss 2007, p. 2</ref>, but there was no significant difference in efficacy between real and ]. | |||
| ==Background== | |||
| In 2000, the paramount decision-making body within the self-government of medical service providers and ] in Germany, known as the ] (''Gemeinsamer Bundesausschuss''), ruled that acupuncture treatment may not be covered by statutory health insurance companies except within the framework of field studies.<ref>Gemeinsamer Bundesausschuss 2007, p. 2</ref><ref>"... beschloss der Gemeinsame Bundesausschuss (B-BA) am 16. Oktober 2000, dass Akupunktur nur noch im Rahmen von Modellvorhaben ... von der Gesetzlichen Krankenkasse bezahlt werden kann." ("... on October 16th 2000, the Joint Federal Committee ruled that acupuncture may only be covered by statutory health insurance companies within the framework of field studies ..." As seen at: Endres et al. 2007, p. C101</ref>{{RS|date=November 2013}} | |||
| Subsequently, the GERAC were set up at ]<ref>"Die wissenschaftliche Gesamtverantwortung für die GERAC-Studien oblag der Abteilung für Medizinische Informatik, Biometrie und Epidemiologie der Ruhr-Universität Bochum..." ("Scientific responsibility for the GERAC studies fell to the department of medicial computing, biometrics and epidemiology at Ruhr University Bochum...") As seen at: Gemeinsamer Bundesausschuss 2007, p.5</ref> in 2001,<ref>"... wurden an der Universität Bochum Anfang 2001 die German Acupuncture Trials (GERAC) ins Leben gerufen, ..." ("... the German Acupuncture Trials (GERAC) were brought into being at Bochum University at the beginning of 2001 ...") As seen at: Endres et al. 2007, p. C101</ref> as a field study on behalf of six health insurance companies.<ref>"Modellvorhaben der AOK, BKK, IKK, Bundesknappschaft, Bundesverband der Landwirtschaftlichen Krankenkassen und Seekasse" ("Field study of AOK, BKK, IKK, Bundesknappschaft, Bundesverband der Landwirtschaftlichen Krankenkassen, and Seekasse") As seen at: Endres et al. 2007, p. C101</ref>{{RS|date=November 2013}} | |||
| ==Overall RCT set-up== | |||
| All RCTs were designed as three-armed trials, with the three parallel groups in each trial receiving either verum (real) acupuncture treatment, sham acupuncture treatment, or guideline-based conventional treatment.<ref>"Entsprechend den Vorgaben des G-BA waren beide dreiarmigen Kopfschmerzstudien für einen Wirksamkeitsvergleich zwischen Verumakupunktur, Shamakupunktur und leitlinienorientierter Standardtherapie konzipiert." ("In accordance with the Joint Federal Committee's specifications, both three-armed headache trials were designed for an efficacy comparison between verum acupuncture, sham acupuncture, and guideline-oriented conventional therapy.") As seen at: Endres et al. 2007, p. C102</ref> The number of patients randomized was one of the largest ever for acupuncture trials.<ref>"Eine weitere Stärke ist eine sehr hohe Power aufgrund der bislang größten Zahl an Patienten, die jemals in Akupunkturstudien randomisiert worden sind." - "Another strength is a very big ] due to the largest sample size of patients ever to be randomized in an acupuncture trial." As seen at: Endres et al. 2007, p. C107</ref> | |||
| Only registered physicians with an additional license for acupuncture and at least two years of clinical experience in acupuncture treatment qualified as performing acupuncturists.<ref>"Kohortenstudie: Studienteilnehmer - An der Kohortenstudie konnten alle niedergelassenen Ärzte mit mindestens einem A-Diplom für Akupunktur (140 Stunden Weiterbildung) teilnehmen ... Randomisiert kontrollierte Studien: Studienteilnehmer und Randomisierung - Die Mindestanforderungen an die Ärzte entsprechen denen der Kohortenstudie. Zusätzlich musste eine mindestens zweijährige Berufserfahrung in Akupunktur nachgewiesen werden." ("Cohort study: Participants - All registered physicians in own practice with at least an A-license (140 hours of advanced training) in acupuncture were allowed to participate in the cohort study ... Randomized controlled studies: Participants and Randomization - The minimum requirements for the doctors were in accordance with the cohort study's. Additionally, a minimum of two years of professional experience in acupuncture had to be substantiated.") As seen at: Endres et al. 2007, p. C102</ref> In order to acquaint them with the study-specific standards of acupuncture, sham acupuncture and conventional therapy, the performing physicians received a one-day training.<ref>"In eintägigen Schulungsveranstaltungen wurden alle Ärzte in die Durchführung der teilstandardisierten Verum- und Shamakupunktur sowie der leitlinienorientierten Standardtherapie eingeführt." ("In one-day training events, all physicians were familiarized with the implementation of semi-standardized verum acupuncture and sham acupuncture, and guideline-based conventional treatment.") As seen at: Endres et al. 2007, p. C102</ref> | |||
| The acupuncture point selection was partially predetermined.<ref>"Die Akupunkturpunkte waren für die Prüfärzte teilstandardisiert vorgegeben." ("Acupuncture points were semi-standardizedly enjoined on the performing physicians.") As seen at: Endres et al. 2007, p. C102</ref> Needles were to be manipulated until arrival of ] sensation,<ref>"... und die Nadel wurde manuell stimuliert bis zum Eintreten eines elektrisierenden Gefühls am Akupunkturpunkt ("De Qi"-Gefühl), ..." ("... and the needle was manually stimulated until arrival of an electrifying sensation at the acupuncture point ("De Qi" sensation) ...") As seen at: Endres et al. 2007, p. C103</ref> which according to ] indicates successful activation of an acupoint. | |||
| For sham acupuncture, needles were inserted only superficially (3 mm at most), and at bogus points; there also was no subsequent manipulation.<ref>"Shamakupunktur war eine oberflächliche Akupunktur (bis maximal 3 mm), ohne Nadelstimulation, an falschen Punkten." ("Sham acupuncture consisted of a superficial acupuncture (to a maximum of 3 mm) without needle stimulation, at bogus points.") As seen at: Endres et al. 2007, p. C103</ref> Thus, only the patients (not the performing acupuncturists) could be ].<ref>"Alle Patienten waren gegenüber der Akupunkturform verblindet." ("All patients were blinded regarding the type of acupuncture.") As seen at: Endres et al. 2007, p. C103</ref> Type and quantity of needles were the same in real and sham acupuncture.<ref>"Nadelart und -zahl ... waren deshalb gleich." ("Needle type and numbers ... therefore were the same.") As seen at: Endres et al. 2007, p. C103</ref> | |||
| Assessment regarding the therapy's efficacy was undertaken by blinded interviewers.<ref>"Auch den Interviewern war die Therapieform unbekannt, ..." ("The type of therapy also wasn't disclosed to the interviewers, ...") As seen at: Endres et al. 2007, p. C103</ref> | |||
| In later years, ] noted that the studies had attracted criticism for not controlling the risk of patient de-blinding, and said that they " to conclusively answer the question whether acupuncture helps patients through a specific or a nonspecific effect".<ref> | In later years, ] noted that the studies had attracted criticism for not controlling the risk of patient de-blinding, and said that they " to conclusively answer the question whether acupuncture helps patients through a specific or a nonspecific effect".<ref> | ||
| {{cite journal|doi=10.1111/j.1365-2796.2005.01584.x|title=Acupuncture - a critical analysis|year=2006|last1=Ernst|first1=E.|journal=Journal of Internal Medicine|volume=259|issue=2|pages=125–37|pmid=16420542}}</ref><ref> | |||
| {{cite journal|doi=10.1007/s00482-005-0404-0|title=Die GERAC-Gonarthrose-Studie|year=2005|journal=Der Schmerz|volume=19|issue=4|pages=330–1; author reply 331–2|pmid=16145742|last1=Wettig|first1=D}}</ref> | |||
| ==Low back pain trial== | |||
| 1162 patients were randomized in this trial.<ref>Gemeinsamer Bundesausschuss 2007, p. 307</ref>{{RS|date=November 2013}} Primary outcome was defined as 33% improvement or better on three pain-related items on the Von Korff Chronic ] questionnaire, or 12% improvement or better on the back-specific Hanover Functional Ability Questionnaire, 6 months after randomization.<ref>Gemeinsamer Bundesausschuss 2007, p. 304</ref><ref>{{cite journal|url=http://archinte.ama-assn.org/cgi/content/abstract/167/17/1892 |last1= Haake|first1=Michael|last2=Müller|first2=Hans-Helge |last3=Schade-Brittinger|first3=Carmen |last4=Basler|first4=Heinz D. |last5=Schäfer|first5=Helmut |last6=Maier|first6=Christoph |last7=Endres|first7=Heinz G.|last8=Trampisch|first8=Hans J. |last9=Molsberger|first9=Albrecht |title=German Acupuncture Trials (GERAC) for Chronic Low Back Pain: Randomized, Multicenter, Blinded, Parallel-Group Trial With 3 Groups|journal=Archives of Internal Medicine|volume=167|issue=17|pages=1892–1898|year=2007 |doi=10.1001/archinte.167.17.1892 |pmid=17893311}}</ref> Treatment given in the standard therapy group consisted of a combination of ] and ] medication.<ref>"... bestand die leitlinienorientierte Standardtherapie aus einer Kombination von physikalischer Therapie und unterstützender Einnahme nichtsteroidaler Antirheumatika." ("... guideline-oriented standard therapy consisted of a combination of physical therapy and additional taking of non-steroidal anti-inflammatories.") As seen at: Endres et al. 2007, p. C111</ref> | |||
| Primary outcome was met by 47.6% of patients in the real acupuncture group, 44.2% of patients in the sham acupuncture group, and 27.4% of patients in the conventional therapy group.<ref>Gemeinsamer Bundesausschuss 2007, p. 307</ref><ref>{{cite journal|url=http://archinte.ama-assn.org/cgi/content/abstract/167/17/1892 |last1= Haake|first1=Michael|last2=Müller|first2=Hans-Helge |last3=Schade-Brittinger|first3=Carmen |last4=Basler|first4=Heinz D. |last5=Schäfer|first5=Helmut |last6=Maier|first6=Christoph |last7=Endres|first7=Heinz G.|last8=Trampisch|first8=Hans J. |last9=Molsberger|first9=Albrecht |title=German Acupuncture Trials (GERAC) for Chronic Low Back Pain: Randomized, Multicenter, Blinded, Parallel-Group Trial With 3 Groups|journal=Archives of Internal Medicine|volume=167|issue=17|pages=1892–1898|year=2007 |doi=10.1001/archinte.167.17.1892 |pmid=17893311}}</ref> This implied both real and sham acupuncture being ] more effective than standard therapy (]<0.001<ref>{{cite journal|url=http://archinte.ama-assn.org/cgi/content/abstract/167/17/1892 |last1= Haake|first1=Michael|last2=Müller|first2=Hans-Helge |last3=Schade-Brittinger|first3=Carmen |last4=Basler|first4=Heinz D. |last5=Schäfer|first5=Helmut |last6=Maier|first6=Christoph |last7=Endres|first7=Heinz G.|last8=Trampisch|first8=Hans J. |last9=Molsberger|first9=Albrecht |title=German Acupuncture Trials (GERAC) for Chronic Low Back Pain: Randomized, Multicenter, Blinded, Parallel-Group Trial With 3 Groups|journal=Archives of Internal Medicine|volume=167|issue=17|pages=1892–1898|year=2007 |doi=10.1001/archinte.167.17.1892 |pmid=17893311}}</ref>); however, there was no statistical significant difference between the effectiveness of real and sham acupuncture (p=0.39<ref>{{cite journal|url=http://archinte.ama-assn.org/cgi/content/abstract/167/17/1892 |last1= Haake|first1=Michael|last2=Müller|first2=Hans-Helge |last3=Schade-Brittinger|first3=Carmen |last4=Basler|first4=Heinz D. |last5=Schäfer|first5=Helmut |last6=Maier|first6=Christoph |last7=Endres|first7=Heinz G.|last8=Trampisch|first8=Hans J. |last9=Molsberger|first9=Albrecht |title=German Acupuncture Trials (GERAC) for Chronic Low Back Pain: Randomized, Multicenter, Blinded, Parallel-Group Trial With 3 Groups|journal=Archives of Internal Medicine|volume=167|issue=17|pages=1892–1898|year=2007 |doi=10.1001/archinte.167.17.1892 |pmid=17893311}}</ref>).<ref>Gemeinsamer Bundesausschuss 2007, pp. 309-310</ref> | |||
| ==Knee osteoarthritis trial== | |||
| A total of 1039 patients were randomized in this study.<ref>Scharf et al. 2006, p. 13</ref> Treatment in the standard therapy group consisted of ] or ] medication on an as-needed basis.<ref>Scharf et al. 2006, p. 13</ref> Patients in the acupuncture and sham acupuncture groups were also allowed additional medication with diclofenac (as needed), but limited to a small amount (i.e., a total of 1g between week 2 and 23).<ref>Scharf et al. 2006, p. 14</ref> Patients in all three groups could attend up to six physiotherapy sessions.<ref>Scharf et al. 2006, p. 14</ref> | |||
| Treatment success was defined as an improvement of at least 36% from baseline ] scores at 13 and 26 weeks after the start of therapy.<ref>Scharf et al. 2006, p. 14</ref> In the end, observed success rates were 53.1% for the acupuncture group, 51.0% for the sham acupuncture group, and 29.1% for the standard therapy group.<ref>Scharf et al. 2006, p. 16</ref> This amounts to significant superiority of acupuncture and sham acupuncture over standard treatment, but no statistical significant efficacy difference between real and sham acupuncture (at p=0.48).<ref>Scharf et al. 2006, p. 16</ref> | |||
| ==Migraine prophylaxis trial== | |||
| In this trial, a total of 960 patients was randomized; immediately after randomization, however, 125 patients (106 from the standard group) withdrew from the study. Primary outcome was defined as reduction in migraine days 26 weeks after randomization.<ref>{{cite journal|url=http://www.sciencedirect.com/science/article/pii/S1474442206703829|last1=Diener|first1=Hans-Christoph|last2=Kronfeld|first2=Kai |last3=Boewing|first3=Gabriele |last4=Lungenhausen|first4=Margitta |last5=Maier|first5=Christoph |last6=Molsberger|first6=Albrecht|last7=Tegenthoff|first7=Martin |last8=Trampisch|first8=Hans-Joachim|last9=Zenz|first9=Michael|last10=Meinert|first10=Rolf |title=Efficacy of acupuncture for the prophylaxis of migraine: a multicentre randomised controlled clinical trial |journal=The Lancet Neurology|volume=5|issue=4|pages=310–316|year=2006}}</ref> Treatment for the standard group consisted of medication according to the 2005 therapy guidelines issued by the German Neurological Association, usually comprising a ].<ref>"Die sechsmonatige, medikamentöse Standardtherapie bei Migräne befolgte aktuelle Leitlinien (... Diener H, Limmroth V, Fritsche G et al.: Therapie der Migräneattacke und Migräneprophylaxe. Leitlinie der Deutschen Gesellschaft für Neurologie und der Deutschen Migräne- und Kopfschmerzgesellschaft...). Sie bestand meist aus der Gabe eines β-Blockers." ("The six-months medicamentous standard therapy adhered to current guidelines (... Diener H, Limmroth V, Fritsche G et al.: Therapy in migraine attacks and migraine prophylaxis. Guidelines of the German Neurological Associationen and the German Association for Migraine and Headache...). In the majority of cases, it consisted of beta-blocker prescription." As seen at. Endres et al. 2007, p. C103</ref> | |||
| Regarding the outcome, an average reduction in migraine days of 2.3 days in the real acupuncture group, 1.5 days in the sham acupuncture group, and 2.1 days in the standard therapy group were observed; this implies no statistically significant difference between the groups. There also was no statistical difference in the numbers of ''responders'' in each group (responding being defined by a reduction in migraine days of at least 50%).<ref>{{cite journal|url=http://www.sciencedirect.com/science/article/pii/S1474442206703829|last1=Diener|first1=Hans-Christoph|last2=Kronfeld|first2=Kai |last3=Boewing|first3=Gabriele |last4=Lungenhausen|first4=Margitta |last5=Maier|first5=Christoph |last6=Molsberger|first6=Albrecht|last7=Tegenthoff|first7=Martin |last8=Trampisch|first8=Hans-Joachim|last9=Zenz|first9=Michael|last10=Meinert|first10=Rolf |title=Efficacy of acupuncture for the prophylaxis of migraine: a multicentre randomised controlled clinical trial |journal=The Lancet Neurology|volume=5|issue=4|pages=310–316|year=2006}}</ref> | |||
| ==Tension-type headache trial== | |||
| The standard, guideline-based therapy arm for the RCT for chronic ] provided for ] medication.<ref>"Die Standardtherapie diente der Anfallsprophylaxe. Beim chronischen Spannungskopfschmerz ist hierzu Amitryptilin ... Mittel der ersten Wahl." ("Standard therapy focused on attack prevention. In this regard, amitryptiline ... constitutes first-line treatment for chronic tension type headache.") As seen at: Endres et al. 2007, p. C102</ref> Although first-line, this usage of amitryptiline was not mentioned in the drug's package insert in Germany at that time.<ref>"Da in den Beipackzetteln der Hinweis auf die Wirksamkeit bei Spannungskopfschmerzen fehlt,..." ("Since efficacy in treating tension type headache is not mentioned in the package insert ...") As seen at: Endres et al. 2007, p. C102</ref> Subsequently, only four patients were willing to try this treatment, and the standard therapy arm had to be aborted.<ref>"... war nur bei vier Patienten die Bereitschaft zur Einnahme vorhanden. Deshalb musste der Standardtherapiearm ... abgebrochen werden." ("... only four patients were willing to take . Therefore the standard therapy arm had to be aborted ...") As seen at: Endres et al. 2007, p. C102</ref> | |||
| In the two remaining arms (real against sham acupuncture), 409 patients were randomized altogether. Successful treatment was defined as a reduction in headache days per month of more than 50%; this primary goal was achieved in 33% and 27% of patients in the real and sham acupuncture group, respectively, representing no significant difference (at p=0.18).<ref>{{cite journal|url=http://www.springerlink.com/content/f664451676xw7q06/ |last1=Endres|first1=Heinz G.|last2=Böwing|first2=Gabriele|last3=Diener|first3=Hans-Christoph|last4=Lange|first4=Stefan|last5=Maier|first5=Christoph|last6=Molsberger|first6=Albrecht|last7=Zenz|first7=Michael|last8=Vickers|first8=Andrew J.|last9=Tegenthoff|first9=Martin|title=Acupuncture for tension-type headache: a multicentre, sham-controlled, patient-and observer-blinded, randomised trial|journal=The Journal of Headache and Pain|volume=8|issue=5|pages=306–314|year=2007}}</ref> | |||
| ==Observational study== | |||
| 12,617 physicians took part in the observational study, reporting on ] during or after acupuncture therapies they performed between 2001 and 2005.<ref>"Im Sommer 2005 nahmen am Modellvorhaben der Krankenkassen 12617 Ärzte ... teil. ("In the summer of 2005, 12617 physicians ... participated in the health insurance companies' field study.") As seen at: Endres et al. 2007, p. C103</ref> This resulted in data of roughly 2.6 million patients,<ref>"Von 2001 bis 2005 trafen in Bochum 2,9 Millionen Faxmeldeformulare von rund 2,6 Millionen Patienten ein,..." ("2.9 million faxed forms representing 2.6 million patients were collected in Bochum between 2001 and 2005,...") As seen at: Endres et al. 2007, p. C103</ref> out of which a random sample of 190,924 was reviewed in terms of frequency of adverse events and ]s.<ref>"In der ersten großen Stichprobe zur Erfassung von UEs und SUEs (190924 Patienten)..." ("In a first big random sample (190924 patients)...") As seen at: Endres et al. 2007, p. C104</ref> | |||
| Adverse events were reported in 7.5% of the cases, including 45 serious adverse events.<ref>"... haben die Ärzte in 7,5 Prozent aller Patienten ein unerwünschtes Ereignis dokumentiert ... Gemeldet wurden 45 SUE, ..." ("... the physicians documented an adverse event in 7.5% of all patients ... 45 SAE were registered, ...") As seen at: Endres et al. 2007, p. C104</ref> The three most frequent adverse events were bruising at the puncture site, temporary worsening of the original symptoms intended to be treated, and ].<ref>"Die drei am häufigsten genannten UE waren das Hämatom an der Einstichstelle, die temporäre Symptomverschlechterung und eine vasovagale Kreislaufreaktion." ("The three most frequently reported AE were hematoma at the puncture site, temporary worsening of symptoms, and vasovagal circulatory reaction.") As seen at: Endres et al. 2007, p. C104</ref> Underreporting of adverse events had to be assumed.<ref>"Da mit einem erheblichen Underreporting von SUEs gerechnet werden musste, ..." ("As considerable underreporting of AE had to be anticipated ...") As seen at: Endres et al. 2007, p. C102</ref> | |||
| ==Consequences== | |||
| As a result of the GERAC trials, the Joint Federal Committee (''Gemeinsamer Bundesausschuss'') decided to include acupuncture into the catalogue of services covered by the German statutory health insurances, for the treatment of low back pain and knee pain.<ref>Gemeinsamer Bundesausschuss 2007, p. 2</ref><ref>"Dieser Überlegenheitsnachweis war die Grundlage für den Gemeinsamen Bundesausschuss, Akupunktur gegen Lendenwirbelsäulen- und Knieschmerzen in den vertragsärztlichen Leistungskatalog zu Lasten der der GKV aufzunehmen." ("The documented evidence of superiority served as rationale for the Joint Federal Committee to include acupuncture into the catalogue of benefits covered by the statutory health insurances, for the treatment of low back pain and knee pain.") As seen at: Endres et al. 2007, p. C115</ref>{{RS|date=November 2013}} | |||
| ==References== | ==References== | ||
| {{reflist |
{{reflist}} | ||
| *{{cite journal|last1=Endres|first1=Heinz G.|last2=Diener|first2=Hans-Christoph|last3=Maier|first3=Christoph|last4=Böwing|first4=Gabriele|last5=Trampisch|first5=Hans-Joachim|last6=Zenz|first6=Michael|title=Akupunktur bei chronischen Kopfschmerzen|journal=Deutsches Ärzteblatt|volume=104|issue=3|pages=C101-C108|year=2007}} | |||
| *{{cite journal|last1=Endres|first1=Heinz G.|last2=Victor|first2=Norbert|last3=Haake|first3=Michael|last4=Witte|first4=Steffen|last5=Streitberger|first5=Konrad|last6=Zenz|first6=Michael|title=Akupunktur bei chronischen Knie- und Rückenschmerzen|journal=Deutsches Ärzteblatt|volume=104|issue=3|pages=C109-C116|year=2007}} | |||
| *{{cite web|url=http://www.g-ba.de/downloads/40-268-487/2007-09-27-Abschluss-Akupunktur.pdf |title=Zusammenfassender Bericht des Unterausschusses "Ärztliche Behandlung" des Gemeinsamen Bundesausschusses über die Bewertung gemäß §135 Abs.1 SGB V der Körperakupunktur mit Nadeln ohne elektrische Stimulation bei chronischen Kopfschmerzen, chronischen LWS-Schmerzen, chronischen Schmerzen bei Osteoarthritis |author=Gemeinsamer Bundesausschuss |date=27 September 2007 |accessdate=5 November 2013 |language=German}} | |||
| *{{cite journal|url=http://www.annals.org/content/145/1/12.full.pdf+html|last1=Scharf|first1=Hanns-Peter |last2=Mansmann|first2=Ulrich |last3=Streitberger|first3=Konrad |last4=Witte|first4=Steffen |last5=Krämer|first5=Jürgen |last6=Maier|first6=Christoph |last7=Trampisch|first7=Hans-Joachim |last8=Victor|first8=Norbert |title=Acupuncture and Knee Osteoarthritis: A Three-Armed Randomized Trial|journal=Annals of Internal Medicine |volume=145|issue=1|pages=12–20|year=2006}} | |||
| ==External links== | ==External links== | ||
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Revision as of 07:06, 20 November 2013
| An editor has nominated this article for deletion. You are welcome to participate in the deletion discussion, which will decide whether or not to retain it.Feel free to improve the article, but do not remove this notice before the discussion is closed. For more information, see the guide to deletion. Find sources: "German acupuncture trials" – news · newspapers · books · scholar · JSTOR%5B%5BWikipedia%3AArticles+for+deletion%2FGerman+Acupuncture+Trials%5D%5DAFD |
The German Acupuncture Trials (GERAC) were a series of acupuncture trials set up in 2001 and published in 2006, that found no significant difference between acupuncture and sham acupuncture.
In later years, Edzard Ernst noted that the studies had attracted criticism for not controlling the risk of patient de-blinding, and said that they " to conclusively answer the question whether acupuncture helps patients through a specific or a nonspecific effect".
References
- Jeremy H. Howick (23 February 2011). The Philosophy of Evidence-based Medicine. John Wiley & Sons. p. 92. ISBN 978-1-4443-4266-6.
- Ernst, E. (2006). "Acupuncture - a critical analysis". Journal of Internal Medicine. 259 (2): 125–37. doi:10.1111/j.1365-2796.2005.01584.x. PMID 16420542.
- Wettig, D (2005). "Die GERAC-Gonarthrose-Studie". Der Schmerz. 19 (4): 330–1, author reply 331–2. doi:10.1007/s00482-005-0404-0. PMID 16145742.
External links
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