Acupuncture for chronic pain: individual patient data meta-analysis (Acupuncture Trialists' Collaboration)
Hugh MacPherson has helped conduct one of the largest studies of acupuncture for chronic
pain conditions, including the conditions of back and neck pain, osteoarthritis and chronic headaches. The project, known as the Acupuncture Triallists' Collaboration, has been led by Dr Andrew Vickers and funded primarily by the US National Institutes for Health and also in part by the UK National Institute for Health Research (NIHR) as part of MacPherson's Programme Grant for Applied Research.
The results were first published in the Archives of Internal Medicine in 2012. Individual patient data from 29 randomized controlled trials with 17,922 patients were analysed and the results show that acupuncture is better than usual care and better than sham (placebo) acupuncture for the treatment of back and neck pain, osteoarthritis and chronic headaches/migraines. From the publication, the authors state, "Our results from individual patient data meta-analyses of nearly 18,000 randomized patients in high-quality RCTs provide the most robust evidence to date that acupuncture is a reasonable referral option for patients with chronic pain."(Vickers et al 2012)
A number of sub-studies have been published (see right hand panel), and a more recently updated and enlarged meta-analysis that includes trials published up to and including 2015. (Vickers et al 2018)
Within MacPherson's Programme Grant, the work of the ATC was developed further, with fresh additional results presented on acupuncture for chronic pain and, in particular, for osteoarthritis (see OAK project).
This programme of research has in part been summarised by the NIHR Dissemination Centre Discover Portal, where it is stated by NIHR that, "Acupuncture is not a placebo for treatment of chronic pain". [NIHR video] [Read NIHR Signal].
Citation for Programme Grant: MacPherson H, Vickers A, Bland M, et al. Acupuncture for chronic pain and depression in primary care: a programme of research. Programme Grants Appl Res 2017;5(3).[Full text]
Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE, Sherman KJ, Witt CM, Linde K. Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis. Arch Intern Med 2012;172(19):1444-1453.
Vickers AJ, Vertosick EA, Lewith G, MacPherson H, Foster NE, Sherman KJ, et al. Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. J Pain. 2018 19(5): 455-474 [Abstract, Full Text]
Witt CM, Vertosick EA, Foster NE, Lewith G, Linde K, MacPherson H, et al. The Effect of Patient Characteristics on Acupuncture Treatment Outcomes: An Individual Patient Data Meta-Analysis of 20,827 Chronic Pain Patients in Randomized Controlled Trials. Clin J Pain. 2019 May;35(5):428–34.[Abstract]
MacPherson H, Vertosick EA, Foster NE, Lewith G, Linde K, Sherman KJ, et al. The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain. Pain. 2017 May;158(5):784–93.
MacPherson H, Vickers A, Bland M, Torgerson D, Corbett M, Spackman E, et al. Acupuncture for chronic pain and depression in primary care: a programme of research. NIHR Journals Library; 2017. (Programme Grants for Applied Research. No. 5.3). [Open Access]
Saramago P, Woods B, Weatherly H, Manca A, Sculpher M, Khan K, et al. Methods for network meta-analysis of continuous outcomes using individual patient data: a case study in acupuncture for chronic pain. BMC Med Res Methodol . 2016: 16(1).
MacPherson H, Vertosick E, Lewith G, Linde K, Sherman KJ, Witt CM, Vickers AJ; Acupuncture Trialists' Collaboration. Influence of control group on effect size in trials of acupuncture for chronic pain: a secondary analysis of an individual patient data meta-analysis. PLoS One. 2014 Apr 4;9(4):e93739. doi: 10.1371/journal.pone.0093739. [Free full text]
MacPherson H, Maschino AC, Lewith G, Foster NE, Witt C, Vickers AJ, et al. Characteristics of acupuncture treatment associated with outcome: an individual patient meta-analysis of 17,922 patients with chronic pain in randomised controlled trials. PLoS ONE. 2013;8(10):e77438.[Free full text]
Vickers AJ, Maschino AC, Lewith G, MacPherson H, Sherman KJ, Witt CM; Acupuncture Trialists’ Collaboration. Responses to the Acupuncture Trialists' Collaboration individual patient data meta-analysis. Acupunct Med. 2013 Mar;31(1):98-100. doi: 10.1136/acupmed-2013-010312.[Abstract]
Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Victor N, Sherman KJ, Witt C, Linde K, Collaboration AT. Individual patient data meta-analysis of acupuncture for chronic pain: protocol of the Acupuncture Trialists' Collaboration. Trials, 2010, 11:90.[Full text]