What personally identifiable information is collected from you through the web site, how it is used and with whom it may be shared.
What choices are available to you regarding the use of your data.
The security procedures in place to protect the misuse of your information.
How you can correct any inaccuracies in the information.
Information Collection, Use, and Sharing
We are the sole owners of the information collected on this site. We only have access to/collect information that you voluntarily give us via email or other direct contact from you. We will not sell or rent this information to anyone.
We will use your information to respond to you, regarding the reason you contacted us. We will not share your information with any third party outside of our organization, other than as necessary to fulfill your request, e.g. to ship an order.
Your Access to and Control Over Information
You may opt out of any future contacts from us at any time. You can do the following at any time by contacting us via the email address or phone number given on our website:
• See what data we have about you, if any.
• Change/correct any data we have about you.
• Have us delete any data we have about you.
• Express any concern you have about our use of your data.
We take precautions to protect your information. When you submit sensitive information via the website, your information is protected both online and offline.
Wherever we collect sensitive information (such as credit card data), that information is encrypted and transmitted to us in a secure way. You can verify this by looking for a closed lock icon at the bottom of your web browser, or looking for “https” at the beginning of the address of the web page.
While we use encryption to protect sensitive information transmitted online, we also protect your information offline. Only employees who need the information to perform a specific job (for example, billing or customer service) are granted access to personally identifiable information. The computers/servers in which we store personally identifiable information are kept in a secure environment.
Menorrhagia affects approximately 30% of women and is a common reason for hysterectomy. Research from China suggests that acupuncture has the potential to provide women with an effective, minimally invasive and acceptable treatment option for Menorrhagia.
The Foundation and the Department of Health Sciences and Clinical Evaluation, University of York, are currently collaborating on a programme of research designed to develop the evidence base as to whether or not women with Menorrhagia should be offered acupuncture on the NHS.
Alison, and NCA graduate and PHill at York University, is the researcher. The programme of research will employ both qualitative and quantitative research methodologies. The first stage of the research is now underway and aims to assess the acceptability of acupuncture as a treatment option for women with Menorrhagia.
The second phase will be a pilot for the final phase of the research programme; a full-scale pragmatic randomised controlled trial to evaluate the clinical and cost effectiveness of acupuncture as a treatment option for women with Menorrhagia assessed as suitable for treatment within primary care.
Pain Project: evaluating the effectiveness of acupuncture in the treatment of low back pain.
Back pain is a major cause of ill health and time lost from work. The ‘orthodox’ treatments often have limited success and the NHS has identified back pain as a priority condition for research. A literature review revealed that acupuncture can be an effective treatment though there is a lack of high quality research trials. The Foundation therefore identified low back pain as a priority research area.
In preparation for a randomised controlled trial, a feasibility study was carried out in which GPs referred four patients with chronic low back pain to an acupuncture clinic in York for a course of ten treatments (Fitter & MacPherson, 1995). The purpose was to test out our methods of assessing the outcomes of treatment. These results were encouraging in terms of procedures, end-point measures and outcomes. A full pilot study was undertaken with twenty patients being referred to two acupuncture clinics in York by local GPs and also by consultants in the Pain Clinic at the NHS hospital in York (MacPherson et al 1999).
In collaboration with Kate Thomas of the Medical Care Research Unit at Sheffield University, this project was developed into a successful application for funding from the Department of Health R & D Health Technology Assessment Programme. The research design is that of a pragmatic randomised controlled trial to evaluate the evidence for the clinical benefits, the cost effectiveness and the safety of acupuncture for chronic low back pain (Thomas et al 1999).
The trial involves 240 patients referred by 35 GPs from the York Primary Care Group and then randomised to the offer of acupuncture or to normal GP management. The acupuncture group will receive up to 10 treatments from 6 acupuncturists based at two centres in York. In-depth interviews with selected patients are helping us capture the patients’ strategies for coping with low back pain and their experience of acupuncture.
The trial started in the summer of 1999 and there will be two years of data collecting before the results of this study can be analysed and published.
Acupuncture in General Practice: a case study of an acupuncturist working in general medical practice.
Much of the research programme is in pursuit of our goal of exploring what role acupuncture could play in the NHS. We are therefore interested in the experience of acupuncturists working within the NHS and in ways of making the collaboration as effective as possible. To this end, we have undertaken a small action research case study to explore the process of establishing and providing an acupuncture service within general medical practice. A practice in Sheffield employed an acupuncturist on a sessional basis to provide treatments for their patients. Mike Fitter contributed research expertise to help set up the clinical audit and monitoring systems. Our aims were to identify:
- the benefits to patients and GPs of offering acupuncture with general practice
- the most effective ways of developing collaborative working and an integrated service.
Data on the clinical outcomes of the acupuncture treatments has been analysed, a symposium report has been presented by acupuncturist Pam Machin and we expect to publish the results as a case study on the delivery of acupuncture within a GP practice.
Concordance studies in Traditional Chinese medicine
Within the Low Back Pain Trial there has been the opportunity to investigate as a sub-study the diagnostic categories of traditional Chinese medicine for low back pain. Given that these back pain categories inform treatment, and because we will be obtaining robust data on outcomes for each category, we will be able to develop some useful data on the value of these traditional Chinese medical categories. To support this investigation, we will evaluate the concordance between acupuncture practitioners in their diagnoses. To establish inter-rater reliability we will use Cohen’s Kappa as a statistical measure agreement over and above chance. This work is being extended to exploring tongue diagnosis in traditional Chinese medicine, establishing the how widely this diagnostic tool is used by acupuncturists as well as assessing levels of practitioner concordance.
The Foundation is a small yet dynamic organisation committed to promoting high quality research into our understanding of acupuncture as well as evaluating the benefits, the cost effectiveness and the safety. Our primary goal is to develop and improve the practice of Chinese medicine and to work towards a more central role for acupuncture within the UK’s national health care system. The Foundation is involved in a number of research projects, the largest of which is a pragmatic randomised controlled trial evaluating the cost effectiveness of acupuncture in the treatment of low back pain. Adverse events following acupuncture are being evaluated in two studies, one a prospective survey of acupuncturist, the other a survey of patients’ experience of adverse events. The Foundation has also had an interest in women’s health which has developed to the point where a preliminary study has been launched exploring the role of acupuncture for women with menorrhagia. The Foundation is also exploring the diagnostic categories of traditional Chinese medicine with the aim of establishing levels of concordance between practitioners.
History of the Foundation
The Foundation was established in 1991 to provide an organisational base for promoting research into acupuncture:
“The goal of the Foundation is, through research and education, to bring the traditional Chinese system of acupuncture more centrally into the national health care system”.
The first period of the Foundation’s existence was focused on the professional acupuncture community and in particular on the need for acupuncturists to be engaged in research both for the benefits of patients and as part of a process of professionalisation. This position was clearly articulated by our first Research Director.
The Foundation became more established with the appointment as Research Director in 1993. His first step was to survey the membership of the British Acupuncture Council and to elicit current attitudes and needs in the area of research. This survey (Fitter & Blackwell, 1993) led to a seminal short training programme in acupuncture research (known as the STAR programme) for acupuncture practitioners. In turn this programme led to a number of subsequent training activities with the participants subsequently conducting their own multi-centred outcomes project where variations in outcomes following acupuncture were investigated (Luty et al 1995, MacPherson & Fitter 1999).
The first clinically based study involved a small feasibility project investigating the use of acupuncture in the treatment of low back pain (Fitter & MacPherson 1995). This project led to a subsequent pilot study where 20 patients participated in a more thorough investigation (MacPherson et al 1999). Based on this, the Foundation in collaboration with Kate Thomas of the Medical Care Unit of Sheffield University set up the York Acupuncture Back Pain Project, funded by the NHS to undertake a pragmatic randomised controlled trial to evaluate the clinical and cost benefits of acupuncture for chronic low back pain (Thomas et al 1999, MacPherson 1999d).
For acupuncturists, there is both an “inner” perspective on research where the aim can be more towards developing practice for the benefit of patients (improving) or an “outer” perspective demonstrating benefits for an external audience (proving) (Fitter, 1997). Mike Fitter and Kate Thomas in collaboration have investigated a number of methodological issues that are of particular importance for research into complementary medicine (Fitter & Thomas 1997, Thomas & Fitter 1997). Emerging themes for research include ensuring that the focus is on studying the therapy as it is actually practised (MacPherson 2000), that the integrity of the therapy is honoured (Wheeler & MacPherson 2000), and that the outcomes of treatment are more diverse and complex than quantitative measures alone can demonstrate (Fitter 1996). In this context she undertook her MSc on patient perspectives on outcome following acupuncture and this study has been submitted for publication (Gould & MacPherson 2000).
A major project for the Foundation has been the collaborative work with the British Acupuncture Council in setting up and running the Acupuncture Research Resources Centre (ARRC) co-ordinated by her between 1994 and 1998. ARRC provided a national information service on acupuncture research and produced a national Directory of Acupuncturists in Research and an acupuncture database known as Arrobas (Gould 1997b). With Foundation staff, ARRC also organised annual symposiums for researchers to gather and present the results of their investigations (Gould 1996b, Gould 1997a, Gould 1999). In 1998, the Acupuncture Research Resources Centre transferred to Exeter University where it continues its important role in supporting research and providing information on acupuncture.
He wrote an early paper on adverse events involving Chinese herbal medicines (1996). More recently the Foundation has focused on studying adverse events following acupuncture (MacPherson & Gould 1998, MacPherson 1998, MacPherson 1999a, MacPherson 1999c, MacPherson & Lewith 2000) and setting up a prospective survey of practitioner reports of significant events and minor transient reactions to acupuncture. This project has led to plans for a survey of patients’ experiences of adverse events following acupuncture.
The Foundation has developed a number of good working relationships with other individuals and organisations in the field, including the Research Council for Complementary Medicine, and centres and/or staff at the Universities of Exeter, Glasgow, Sheffield, Southampton, Westminster and York. The staff of the Foundation have also participated in a number of national initiatives that involve promoting or developing the role of complementary medicine in the UK. These initiatives include the Labour Party’s 1994 position paper “From Prescription to Facilitation” and the Research Council for Complementary Medicine’s national audit project. The Foundation also contributed to the Prince of Wales initiative with the Foundation for Integrated Medicine (FIM), widening the debate on research strategies for complementary medicine (Thomas & Fitter 2000). In turn this has led to the Foundation providing evidence for the Science and Technology Committee of the House of Lords who will be reporting to the Government early in 2001.
Foundation for Traditional Chinese Medicine
A centre for acupuncture research
1221C Acomb Rd