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“Start as you mean to go on” is the saying that comes to mind as I look upon this latest issue of Acupuncture in Medicine, my first as your new Editor-in-Chief. Beneath the new-look cover lies a mix of many different types of research articles, highlighting the diversity in what might otherwise be considered a rather niche area of medical practice and scientific investigation.
We begin with two review articles: one systematic; one narrative; both topical. Vados et al considered the potential role of acupuncture as an adjunct to standard care (rehabilitation) following acute or subacute stroke in a review of 17 randomised controlled trials, most of which were conducted in China. This is a timely update considering the recent plethora of basic science articles reporting neuroprotective effects of acupuncture in animal models of stroke. Although their results are encouraging, the relative lack of high quality trials (5 of 17) limits the conclusions that can be drawn and highlights the need for further clinical research in this area. Meanwhile, Halsey et al examined the role of acupuncture in the management of aromatase inhibitor induced musculoskeletal syndrome (AIMSS) and found evidence of benefit when compared with standard care but not with sham acupuncture. As the numbers were small (n=32–67) these trials were greatly underpowered to detect differences between verum and sham acupuncture, thus the relative contributions of specific versus non-specific effects of needling for this particular condition remain unclear.
My editor's choice for this issue is the recent RCT by Liodden et al, which demonstrated no measurable effect of PC6 acupuncture on nausea and vomiting post-tonsillectomy in Norwegian children aged 1–11 compared with untreated controls. Their negative result contrasts with the latest Cochrane review of 40 trials (n=4858 patients) on PC6 stimulation for the prevention of post-operative nausea and vomiting,1 and raises the question whether there should be additional considerations regarding dose and context in paediatric patients. Irrespective, their study showcases many of the hallmarks of quality that we are looking for in submissions including prospective registration, which is now a prerequisite for publication in Acupuncture in Medicine, as outlined by my latest editorial.2 It also highlights our willingness as a journal to promote negative as well as positive trials, in order to minimise publication bias in our field. Next up, Li et al share their positive findings from a single-blind crossover trial of verum versus sham acupuncture for diabetic gastroparesis that, incidentally, provided the inspiration for our first issue-specific cover image.
The remainder of this issue is devoted to alternative research designs including a qualitative study, a survey, a pharmacokinetic study (atypical for our journal) and a bioelectrical experiment. Bardy et al examined the acceptability of self-acupuncture, as was used in their recent trial,3 to patients with breast cancer-related fatigue and their practitioners, and revealed general enthusiasm. Jin et al looked at attitudes towards sham acupuncture amongst practitioners in China, an important consideration given the increasing contribution of Chinese research to the acupuncture literature. Ji et al showed that ST36 acupuncture alters the handling of herbal metabolites in the body, highlighting the potentially synergistic effects of the various elements of Traditional Chinese Medicine. Finally, Khorsand et al demonstrated no changes in electrical impedance after needling at various acupuncture points, an important negative result that contributes to the point specificity debate.
All in all, we have a nice blend of articles from around the world with diverse methodologies. It is exactly this type of variety that I hope to foster for years to come as the Acupuncture in Medicine team strives to secure the journal's position as the world's premier scientific acupuncture publication.
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