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This latest issue of Acupuncture in Medicine opens with the editor's choice article. Chai et al. present the results of their systematic review of randomised controlled trials of acupuncture to treat melasma in women. Although eight trials met criteria for inclusion, significant heterogeneity prevented any meta-analysis and limited their conclusions. Nevertheless, the limited available evidence suggests that acupuncture for melasma is potentially effective and safe. One of the main strengths of this work was its prospective registration in the international database PROSPERO, which is maintained by the Centre for Reviews and Dissemination at the University of York (http://www.crd.york.ac.uk/PROSPERO). In the June issue of Acupuncture in Medicine, the mandatory requirement for clinical trials to be prospectively registered in a publicly accessible database (to comply with the revised Declaration of Helsinki) was emphasized.1 Whilst systematic reviews do not impose the same ethical obligations as primary research involving human subjects, registration of research syntheses and observational studies serves a similar purpose to trial registration from a research quality perspective, and is encouraged, albeit not required, by the International Committee of Journal Medical Editors. Prospective registration (or publication) of a systematic review protocol helps prevent unnecessary duplication of the work by others and reduces potential bias by ensuring the primary outcome is defined a priori and that the precise research question, search criteria, inclusion/exclusion criteria, data management and statistical analysis are agreed up front.2
Elsewhere in this issue you will find no fewer than five randomised controlled trials of acupuncture and related techniques, ranging in size from a small comparative effectiveness study of manual acupuncture versus clonazepam for burning mouth syndrome by Jurisic Kvesic et al. (n=42) to a large multi-centre trial of “heat-sensitive” moxibustion for knee osteoarthritis by Chen et al. (n=432). In addition, Tzeng et al. and McKeon et al. report on their pilot studies of electroacupuncture for chemotherapy-induced nausea and vomiting and post-operative pain, respectively, and Liu et al. evaluate peri-operative transcutaneous electrical acupuncture point stimulation in patients undergoing brain surgery. This diverse assortment of trials is followed by an appraisal by Kim et al. of a new sham press needle, which their volunteers were unable to reliably distinguish from a penetrating press needle. This is encouraging, however it remains unknown whether this sham needle is truly inert and/or whether it will achieve successful blinding of patients in randomised controlled trials.
Next come three basic science studies which add to the mushrooming literature on the anti-inflammatory and immunomodulatory effects of acupuncture, as recently brought to the fore by the ground-breaking work of Torres-Rosas et al.3 Here, Zhu et al. and Xue et al. demonstrate anti-inflammatory effects of electroacupuncture in rats with rheumatoid arthritis and severe acute pancreatitis, respectively, while Watanabe et al. reveal stimulation of the innate immune system following manual acupuncture in stressed mice. These papers are followed by the novel work of Huang et al. characterising electrical activity at myofascial trigger points, treatment of which is central to the practice of Western medical acupuncture.
The issue concludes with a case report of a Parkinson's disease patient by Fukuda and Egawa, which also provided the inspiration for our second issue-specific cover image. Readers should note that, effective from 1st July 2015, Acupuncture in Medicine no longer accepts case reports for publication, but will reprint acupuncture-related cases that have been published in BMJ Case Reports in the paper version of the journal. Peer review of acupuncture cases submitted to BMJ Case Reports will be coordinated by the Acupuncture in Medicine editorial team and “fellowship” fees will be waived for BMAS members—see our website for further information (http://aim.bmj.com/site/about/guidelines.xhtml).
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