Clinical research can never prove that an intervention has an effect size of zero. Rather, clinical research assumes the null hypothesis, that the treatment does not work, and the burden of proof lies with demonstrating adequate evidence to reject the null hypothesis. So, when being technical, researchers will conclude that a negative study “fails to reject the null hypothesis.”
Further, negative studies do not demonstrate an effect size of zero, but rather that any possible effect is likely to be smaller than the power of existing research to detect. The greater the number and power of such studies, however, the closer this remaining possible effect size gets to zero. At some point the remaining possible effect becomes clinically insignificant.
In other words, clinical research may not be able to detect the difference between zero effect and a tiny effect, but at some point it becomes irrelevant.
What David and I have convincingly argued, in my opinion, is that after decades of research and more than 3000 trials, acupuncture researchers have failed to reject the null hypothesis, and any remaining possible specific effect from acupuncture is so tiny as to be clinically insignificant.
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