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Lessons to Be Learned: Changing Perspectives in Acupuncture Research
Methodology Translated to Osteopathic Manipulative Therapy Clinical
Trials
McCallister, A, BA, OMSIV; .Ferrill, H, D.O. 1 , Dobos, G, M.D. 2 , Tao, I, M.D. 2
1 UNECOM, Department of Osteopathic Manipulative Medicine, Biddeford, ME
2 University of Duisburg-Essen, Department of Integrative Medicine, Essen,
Germany
Introduction: Osteopathic Manipulative Therapy (OMT) research faces many
methodological challenges, especially when placed into an atmosphere
dominated by the Randomized Control Trial (RCT). Two central postulates of
RCTs are randomization and control. Any intervention is thus thought to be
divided into characteristic (specific) and incidental (placebo, non-specific)
effects. But does it make sense to split complex interventions such as OMT
into characteristic and incidental effects? Recent research has shown that
elements categorized as “incidental” in drug trials are integral to
interventions such as acupuncture. Since OMT also cannot separate its
characteristic and incidental effects, we may learn something from recently
suggested shifts in acupuncture methodology. The field of acupuncture is moving
away from the explanatory design and shifting towards pragmatic trials to better
study acupuncture as it is actually performed in practice. As a field, they have
also developed research reporting guidelines (the STRICTA standards) to
improve transparency of research design and results. In the same vein, OMT
research would also benefit from standardization of research reporting.
Methods: This work is based on a PubMed literature search in the fields of
acupuncture and OMT research methodology and is a translational work across
these two fields.
Results: Three suggestions to improve research transparency are presented
here. The first would be to implement a set of reporting guidelines, specifically
tailored to OMT research that would be designed from acupuncture’s STRICTA
guidelines. The second would be to use a questionnaire for research participants
to determine the believability of the chosen control condition, similar to the
questions proposed by Fulda et al. The third is implementing a graphing method
designed by Thorpe et al. to consolidate aspects of OMT trial design. This tool
will better determine where each study falls on the pragmatic-explanatory
spectrum and would also demonstrate the external validity of each study.
Conclusion: The goal of these proposed measures is not to dictate research
methodology but to increase transparency with clinical trial study design and
findings. These tools should improve the quality of manuscript reporting and
allow OMT researchers to look objectively at the appropriateness of research
paradigms currently employed for OMT research.