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The patient-practitioner relationship in acupuncture
Profit from a wealth of experience in interactions with your patients! The Patient-Practitioner Relationship in Acupuncture is written for acupuncturists and practitioners in the fields of alternative medicine searching for: * effective ways of connecting better with their patients in all their diversity, and * the skills necessary to guide patients through emotional, psychological, and spiritual difficulties as part of the healing process. Dr. Hammer bases his work on the universally accepted and fundamental role the therapeutic relationship plays in the practitioner's ability to heal and his lifelong observation that both the patient and the practitioner benefit from this vital relationship. Drawing from his long and extensive personal and professional experiences and writing in an easily understandable and at times anecdotal style, the author avoids psychological jargon as much as possible. The material is presented independent to pathology and is organized into two parts: The first part outlines the basic tenets of the therapeutic relationship, and the second, main part presents individual, issue-oriented chapters addressing the varied life situations, personalities, and emotional reactions with which the acupuncturist or practitioner is confronted in everyday practice. Let this handy reference become your constant and reliable companion on your path to: * enhancing your propensity and innate talents to heal, * improving your therapeutic skills within the scope of your practice, and * gaining confidence in your interactions with your patients.
eBook
Developing a deep learning model for the automated monitoring of acupuncture needle insertion: enhancing safety in traditional acupuncture practices
Background
Acupuncture is a widely practiced traditional therapy, yet safety concerns, particularly needle breakage and retention, remain critical issues that can lead to complications such as infections, organ injury, or chronic pain. This study aimed to develop a deep learning model to monitor acupuncture needle insertion, detect instances of needle breakage, and prevent needle retention, ultimately improving patient safety and treatment outcomes.
Methods
A deep learning model based on the YOLOv8 architecture was trained using a dataset comprising 192 images from a commercial image library and 73 clinical images captured during real-world acupuncture sessions. Images were preprocessed through cropping and annotation, and augmented to enhance model generalizability. Five-fold cross-validation was employed to ensure robust performance. Model evaluation metrics included precision, recall, F1 score, and mean average precision (mAP) at Intersection over Union (IoU) thresholds of 50% (mAP@50) and 50–95% (mAP@50–95).
Results
The model demonstrated strong performance, achieving an average precision of 88.0% and a recall of 82.9%. The mean average precision was 88.6% at mAP@50 and 62.9% at mAP@50–95, indicating high reliability in detecting acupuncture needles across diverse scenarios. These results highlight the potential of the model to enhance clinical safety by minimizing risks associated with needle breakage and retention, regardless of practitioner experience or patient demographics.
Conclusions
The proposed YOLOv8-based deep learning model offers a reliable method for real-time needle monitoring in acupuncture. Its integration into clinical workflows can improve safety and efficiency, especially in underserved regions or settings with less experienced practitioners. Future research should validate the model with larger, more diverse datasets and explore its application in various healthcare settings.
Trial registration
Not applicable; this study did not involve a healthcare intervention requiring registration. Data collection adhered to ethical standards with institutional approval (TCHIRB-11310004).
Journal Article
Patient feedback for acupuncture practice improvement: A survey from Mayo Clinic
ObjectiveTo understand patient satisfaction with acupuncture appointment duration for the first and subsequent appointments in the plan of care, time spent with the acupuncture provider, willingness to pay for longer duration appointments, and lack of insurance coverage.MethodsPatients who were referred for an acupuncture consult to the Center for Integrative Medicine at Mayo Clinic were asked to participate in the survey in August 2014. Patients were given paper survey at time of appointment check-in and entered into Research Electronic Data Capture Survey database tool to reveal patient-reported outcomes.ResultsIn total, 104 of 329 patients receiving acupuncture treatment responded to the survey with a 32% response rate. Insight and recommended changes to the duration of the initial and subsequent appointments were obtained. Most patients reported that time spent with the provider (76 cases, 74%) and appointment length (74 cases, 68%) were \"just right\". Seventy cases (70%) of respondents indicated that they wanted longer treatment. Patients reported return appointments with duration of 30 min was not enough. Fifty-three patients (62%) were willing to pay for additional costs not covered by insurance.ConclusionsWe used patient feedback to assess the acupuncture practice in a complementary and integrative medicine program. Most patients referred for the acupuncture consult appeared to be satisfied with the current level of practice. These findings were used to establish a quality improvement plan that may be implemented to improve patient satisfaction with the acupuncture practice.
Journal Article
Exploration of Stratified Evidence Scoring Method of Acupuncture Clinical Practice Guidelines
Due to its own internal laws of development, Chinese medicine (CM) seems more inclined to empirical medicine in a relatively long historical period. It is considered to be lacking objective and unified clinical practice guidelines (CPGs), and the difficulties in diagnosis and therapeutic effect evaluation comes with it, have restricted its further inheritance, development and international communication. Over the years, our research group has been committed to improving the standardization theory and methodology of CM, also perfecting relative techniques for further application, which are all based on the stratified evidence scoring method. We have already applied this method to 45 issued guidelines, including 5 national guidelines, 3 industrial guidelines, and 37 formulation/revision social organization guidelines. The stratified evidence scoring method has been recognized and used widely. It helps scholars and applicators to study, formulate, publish and popularize the acupuncture therapy clinical practice guidelines better, thus further promotes the development of acupuncture therapy.
Journal Article
Developing an Acupuncture Service for Chronic Pain
This chapter contains sections titled:
Introduction
Rationale for setting up an acupuncture clinic for pain management
Staff development: education and maintaining competencies
Clinical governance
Conclusions
Editors' note
References
Book Chapter
The immunomodulatory mechanisms for acupuncture practice
The system physiology approaches that emerge in western countries in recent years echo the holistic view of ancient Traditional Chinese Medicine (TCM) practices that deal with the root, rather than only the symptoms of diseases. Particularly, TCM practices, including acupuncture, emphasize the mobilization of self-healing mechanisms to bring back body homeostasis. Acupuncture has been practiced for over two thousand years to modulate body physiology via stimulation at specific body regions (acupoints). With the development of various research on acupuncture therapy, its regulatory effect on the immune system has been gradually recognized, especially on immunological diseases, including infectious and allergic diseases. In this study, we reviewed the immunomodulatory mechanism of acupuncture and systematically integrates existing research to respectively elucidate the modulatory mechanisms of acupuncture on the innate immune system, adaptive immune system, and well-known neuroanatomical mechanisms, including intact somatosensory-autonomic reflex pathway. With the advances made in recent systems physiology studies, we now have a great opportunity to gain insight into how acupuncture modulates immunity, and subsequently improves its efficacy.
Journal Article
Efficacy and Safety of Acupuncture for Chronic Discogenic Sciatica, a Randomized Controlled Sham Acupuncture Trial
Abstract
Objective
To evaluate the efficacy and safety of acupuncture for discogenic sciatica.
Design
Single-center, parallel, randomized controlled sham acupuncture trial.
Methods
Twelve sessions of acupuncture or sham acupuncture at the same traditional acupoints over four weeks. The primary outcome was change from baseline in weekly mean leg pain, measured by the visual analog scale (VAS) over the four-week treatment period. The secondary outcomes were determined by the change from baseline in mean VAS scores for leg pain, VAS scores for low back pain, Oswestry Disability Index (ODI) scores, and 36-Item Short Form Health Survey (SF-36) scores. Patients were followed for 28 weeks.
Results
Forty-six patients were enrolled in this study between June 2017 and January 2018, of which 23 were in the acupuncture group and 23 were in the sham acupuncture group. The between-group difference in weekly mean leg pain measured by the VAS over the four-week treatment period was –7.28 mm (95% confidence interval = –13.76 to –0.80, P = 0.029), which is larger than the minimum clinically important difference of 5 mm. The between-group differences in mean VAS scores for low back pain, ODI scores, and SF-36 scores were not significant in the study period (P > 0.05 for all). The proportion of acupuncture-related adverse events was 4.3%, and all adverse events were mild and transient.
Conclusions
Twelve sessions of acupuncture showed short-term clinical benefits in relieving the symptoms of leg pain for patients with chronic discogenic sciatica compared with sham acupuncture. Acupuncture is safe in treating chronic discogenic sciatica. Further studies with larger sample sizes, a longer treatment period, and long-term follow-up should be conducted to verify these results.
Journal Article
Participant experiences receiving acupuncture for acute musculoskeletal pain in an emergency department: A qualitative evaluation
Acupuncture is an evidence-based pain treatment in clinic settings, but its optimal delivery has not been established in emergency departments (EDs). As part of an adaptive pragmatic randomized controlled trial of ED acupuncture for acute musculoskeletal pain (NCT04290741), we embedded a qualitative evaluation of acupuncture treatment acceptability and suggestions for improvement from study participants receiving acupuncture in the ED.
Semi-structured interviews conducted remotely evaluated factors impacting patients' perspectives, willingness to participate in, and experiences with ED acupuncture. The codebook was iteratively developed, and recruitment and analysis continued until information saturation was reached.
Twenty-eight participants receiving ED acupuncture between February 2020-March 2021 were interviewed, with median age 44 years, 46.4% female, and 61% having never previously received acupuncture. Overall, ED patients with acute musculoskeletal pain expressed interest in acupuncture and reported an overall positive experience. Most reported acupuncture met their expectations for pain improvement, and many reported additional improvements in stress, anxiety, and sleep quality. Participants with a positive experience were more likely to recommend acupuncture to others. Key positive aspects included open communication with compassionate and knowledgeable acupuncturists. Participants found the ED setting acceptable and convenient for receiving acupuncture. Furthermore, participants provided actionable feedback like addressing fear of needles to improve the ED acupuncture experience.
In conclusion, ED patients with acute musculoskeletal pain were interested in and had positive experiences with acupuncture treatment for pain and found the ED setting acceptable and convenient. Participant feedback can be used to improve acupuncture treatment in the ED.
Journal Article
Acupuncture combined with Chinese herbal medicine for discogenic low back pain: protocol for a multicentre, randomised controlled trial
IntroductionDiscogenic low back pain is a common form of chronic low back pain. In traditional Chinese medicine, combinations of acupuncture and herbal medicine are frequently used to manage this condition. However, evidence for the efficacy of a combined approach remains scarce. To address this gap, we designed a multicentre, randomised controlled trial to compare the effects of the combined use of acupuncture and Chinese herbal medicine, and their separate applications along with non-steroidal anti-inflammatory drugs, in treating discogenic low back pain.Methods and analysisThis is a multicentre, prospective, randomised, four-arm, parallel-controlled trial involving patients with discogenic low back pain. Patients will be randomly divided into four groups (acupuncture combined with herbal medicine, acupuncture, herbal medicine and positive drug control) at a 1:1:1:1 ratio. All patients will undergo a 4-week treatment regimen consisting of acupuncture (active or sham acupuncture) and oral medication (herbal medicine or placebo granules and celecoxib or placebo capsules), as well as a 3-month follow-up assessment. The primary outcome measure will be pain intensity, measured using the Visual Analogue Scale after a 4-week treatment period. Secondary outcome measures will include the lumbar pressure pain threshold, pain-related disability measured using the Oswestry Disability Index, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, 36-Item Short-Form Health Survey and incidence of adverse events. Assuming an SD of 1.8, minimal clinically important difference of 1.5 and a 10% dropout rate, at least 97 participants per group are needed, totalling 388 participants.Ethics and disseminationThe study was approved by the Ethics Committee of Dongzhimen Hospital Affiliated with Beijing University of Chinese Medicine (approval number: 2024DZMEC-083-03) and the other seven participating subcentres. All participants will provide written informed consent. This trial will be conducted in accordance with the principles outlined in the Declaration of Helsinki and its amendments. This work will be disseminated through the publication of peer-reviewed manuscripts.Trial registration numberChiCTR2400082428.
Journal Article