NICE guideline on osteoarthritis: is it fair to acupuncture? No.
A new guideline on the care and management of osteoarthritis has recently been published by the National Institute for Health and Clinical Excellence, and makes wide-ranging and authoritative recommendations. The guideline states that there is insufficient evidence to recommend acupuncture. There appears to be three areas where the guidelines may have not used the available evidence in the most appropriate manner. First, data on the long-term effectiveness of acupuncture may have been misinterpreted. Second, the specific rejection of electroacupuncture indicates a restricted understanding of acupuncture as a treatment, and is based on a cost-effectiveness analysis which may not be ideal. Third, the cost-effectiveness calculations used comparisons with sham acupuncture ("placebo") when comparison with standard care would have been more appropriate. The guideline may therefore lead some patients with osteoarthritis to miss out on a treatment that may be effective for them.
White
Adrian
A
Peninsula Medical School, N32 ITTC Building, Tamar Science Park, Plymouth PL6 8BX, UK. Adrian.white@pms.ac.uk
D000047:Academies and Institutes; D015670:Acupuncture Therapy / Q000191:economics / Q000379:methods*; D001291:Attitude of Health Personnel; D015671:Electroacupuncture / Q000379:methods; D006801:Humans; D010003:Osteoarthritis / Q000191:economics / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration*; D011785:Quality Assurance, Health Care; D013222:State Medicine; D006113:United Kingdom