Prof. Konrad Streitberger

About Prof. Konrad Streitberger


Bern University Hospital, Switzerland


Title: Placebo in acupuncture research

Related Session: Paradoxes in Acupuncture Research


PD Dr. med. Konrad Streitberger is the head of the acute pain service of the department of Anaesthesiology and Pain Medicine of the Inselspital, University of Bern, Switzerland. 

He graduated at the University of Heidelberg, Germany in 1998 and worked as anaesthetist and pain specialist at the University Hospitals of Heidelberg, Vienna and Bern. Since 1996 he has been investigator of several clinical randomized acupuncture trials. He published more than 20 articles as author or co-author in indexed international journals. His invention of a new acupuncture-placebo method was awarded with the Seirin-Junior-Science-Price in 1999. PD Dr. Streitberger received his postdoctoral lecture qualification in Anaesthesia at the University of Heidelberg in 2007 and at the University of Bern in 2011. Currently he is a member of the scientific committee of the German physician association of acupuncture (DÄGfA).




Q1.

Here’s the first question that I mentioned before. How did you come up with the idea of making the Sham Acupuncture?


Yeah.


Q2.

It’s quite interesting looking.


When I was a student at the University, I wanted to do an acupuncture trial. And I thought about how can I do a good control… how can I do a placebo acupuncture. And I knew there are some studies that used just like cocktail sticks to mimic … or to do some kind of sham procedure. And I knew there are other studies, they used acupuncture needles but stick it into points which are not acupuncture points. So both had problems, I thought. The cocktail sticks, they don’t really look like acupuncture, so they’re not placebo. And if you stick needles into non-acupuncture points, you have physiologic effects… effects from penetrating the skin. So I thought, there should be something which looks like real acupuncture but which don’t penetrate the skin.


And so at first, I take a needle and I cut the needle… and uh… so I had a blunt needle without… And I tried and said, okay you can take it and put it to the skin but if you… but it won’t stick to the skin. And then, also, if you just put it to the skin, patient might see you just put it there, it’s not going into them. So I thought about it… like a, you know, a stage dagger? or something like they do in the theater with a sword or with a dagger which moves together. So I thought maybe you can use a needle which is going together, moving together.


And uh, so I, I also I took the needle and put it, take it out and tried to work with it and so I found out that you can actually take a real acupuncture needle and you can uh… do sham needle from the real acupuncture needle.


And then… then last problem was the needle still retracted. The needle… still didn’t keep on the skin, so fall down. Then I did some device like uh… a small ring, you can put it on the skin, you can cover with a Band-Aid or with a plaster and then you can put the needle in, so the needle sticks on the skin.


Now if I wanted to do an acupuncture trial, I can take a real needle, put it into this band-aid and do real acupuncture or in the other group, I can do this band-aid and take a sham needle, go through into the ring and it retracts and it looks like real acupuncture but don’t penetrate the skin. So that was the briefest ? of the placebo effect. 


Q3.

Okay, thank you. It’s of intelligent


Thanks.


Q4.

Yeah, very creative that you thought about that theatric effect, dagger, yeah. Here’s another question. People are talking about the limitation of the sham acupuncture still and there are lots of, a quite a few more sham acupunctures that are developed as well? So from your view, what is the limitation of your sham acupuncture device and do you have any ideas to improve it?


One limitation of course that it’s only single blind. It’s only possible to do single blind studies, there’s no double blinding. And the other limitation is that, the needle you have that, you need a contact onto the skin, and if you have contact with the skin, then there might be some kind of acupressure effect. On the other side, if you don’t have contact with the skin, maybe the patient might realize that it’s not real acupuncture, so there’s some kind of paradox. So you don’t really have a good solution for this. 


But at least it’s one device you can use for research if you have a specific question, If you want to know, if penetration of the skin is better than no penetration.


Q5.

Okay, I see. Thank you very much.


It’s Okay? Thank you for your interest.


Q6.

Thank you for doing this interview with us.


You’re welcome.



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