Independent evidence-based health care

Bandolier is always attracted to systematic reviews claim-ing to find strong evidence about a treatment effect. Strong evidence is not easy to find, but one expects a rock on which good practice can be built. When strong evidence and acu-puncture are used in the same sentence, though, Bandolier begins to smell a rat. Not because of any bias, but because good evidence indicates that acupuncture does not work. It should be an educational experience, then, to see how a review of acupuncture for elbow pain [1] stacks up against the requirements of quality, validity, and size (QVS). What does this mean? ♦ Quality: trials that are randomised and double blind, to avoid selection and observer bias, and where we know what happened to most of the subjects in the trial. ♦ Validity: trials that mimic clinical practice, or could b