Annals of Internal Medicine, tip sheet, Dec. 21, 2004

1. Three Articles Study Acupuncture and Manipulation for Spine and Joints

Three articles and an editorial in the Dec. 21, 2004, issue of Annals of Internal Medicine examine several complementary and alternative medicine (CAM) treatments for very common medical conditions.

A study of 570 people in a randomized, controlled trial comparing acupuncture with sham acupuncture and education to treat osteoarthritis of the knee found that acupuncture, used in addition to regular arthritis care, is effective (Article, p. 901).

A second study of 138 patients who received either acupuncture or sham acupuncture for chronic neck pain found that acupuncture was no more effective than placebo (Article, p. 911).

A third study found that an existing clinical prediction rule was successful in identifying low-back-pain patients who are most likely to benefit from spinal manipulation (Article, p. 920).

An editorial writer says that these studies and larger ones are needed (Editorial, p. 957). "If public and private insurance plans are to cover these treatments, it is only fair to hold [them] to the same scientific standards we expect of conventional care."

2. Veterans Health Care Scores Well on Overall Quality Compared with National Sample

A new, comprehensive study of the quality of health care provided by the Veterans Health Administration found VHA patients generally received better care than patients in other settings (Improving Patient Care, p. 938). VA care scored best in areas in which the VHA routinely monitors quality.

In one of the most comprehensive comparisons between VHA care and other care, researchers looked at the quality of acute, chronic and preventive care in 26 medical conditions and compared the care with a national sample in 12 communities. Overall, VHA care scored higher for both adjusted overall quality of care and chronic and preventive care but not for acute care.

NOTE: Annals of Internal Medicine is published by the American College of Physicians, an organization of 116,000 internal medicine physicians and medical students. These highlights are not intended to substitute for articles as sources of information.