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Acupuncture for Chronic Neck Pain Project
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The
evidence on acupuncture remains inconclusive, indicating the need for further well-designed research. The
aim of this study was to conduct a pilot randomised controlled, parallel arm trial,
complemented with qualitative research, to establish key features required for the design
and implementation of a large-scale trial on acupuncture for chronic neck pain. In this project and based at the University of York, we have conducted
this pilot study, led by MRC funded MSc student Gemma Salter. Collaborators include Professor
David Torgerson, Director of the York Trials Unit, and GP advisor Dr Mark Roman.
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Key publication:
Salter
G, Roman M, MacPherson H. Acupuncture for chronic neck pain: a pilot for a randomised
controlled trial. BMC
Musculoskelet Disord. 2006 Dec 9;7(1):99. [Full text]
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Methods:
Patients
whose GPs had diagnosed neck pain were recruited from one general practice, and randomised
to receive usual GP care only, or acupuncture (up to 10 treatments over 3 months) as an
adjunctive treatment to usual GP care. The primary outcome measure was the
Northwick Park Neck Pain Questionnaire (NPQ) at 3 months. A sub-sample of patients and
acupuncturists as well as two GPs were interviewed to explore perceptions and experiences
of acupuncture as a treatment for chronic neck pain.
Results:
A
total of 27 eligible patients consented and 24 were recruited to the trial from the 227
identified from the GP database. Ten patients were randomised to acupuncture, receiving an
average of 8 treatments from one of four acupuncturists, and 14 were randomised to usual
GP care alone. Assuming 80% power at the 5%
significance level, and the standard deviation of baseline scores on the Northwick Park
Questionnaire from this pilot, with an estimated effect size of 0.3, a sample size of 210
would be required in each arm in a large-scale trial to allow for a loss to follow-up rate
of 14%. In order to achieve this sample, one would need to identify patients from
databases of GP practices with a total population of 250,000 patients, or approximately 20
GP practices roughly equal in size to the one involved in this study (i.e. 15,694
patients).
Conclusions:
This pilot study has allowed numerous recommendations to be made to facilitate the
design of a large-scale trial, which in turn will help to clarify the existing evidence
base on acupuncture for neck pain.
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