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Risk of dementia in patients with non-haemorrhagic stroke receiving acupuncture treatment: a nationwide matched cohort study from Taiwan’s National Health Insurance Research Database
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  • Published on:
    Decreased risk of dementia in patients with non-haemorrhagic stroke using acupuncturetreatment: benefit or time-related and residual compounding biases ?
    • Ji-Young Yang, pharmacy PhD. student Sungkyunkwan University
    • Other Contributors:
      • Jung-Eun Hwang, pharmacy PhD. student
      • Ju-Young Shin, Professor

    Corresponding author:
    Ju-Young Shin, PhD
    Professor of Pharmacy
    School of Pharmacy
    Sungkyunkwan University

    Dear Sir

    We read with great interest the study by Chun-Chuan Shin et al1 assessing the effects of acupuncture treatment on the risk of dementia in patients with stroke. They conducted a retrospective cohort study with 5,610 patients in acupuncture group and 5,610 in the non-acupuncture group using data from the National Health Insurance (NHI) system. The authors found that acupuncture treatment reduces the risk of dementia (hazard ratio [HR]: 0.73, 95% confidence interval [CI]: 0.66 to 0.80) compared with the non-treatment group. However, we are concerned that these observed beneficial effects of acupuncture treatment are the results of immortal time bias.

    In the study, cohort entry was defined as patients with no records of stroke within 5 years before the index date and patients who received at least five (5) courses of acupuncture treatment after stroke admission (exclude patients with stroke with only one (1) to four (4) courses of acupuncture treatment). The index date for both groups was defined by the discharge date following stroke admission, and the follow-up for the acupuncture group started from the first date of receiving acupuncture treatment after the index dateuntil 31 December 2009 or until the dementia event occurred. The authors calculatedthe follow-up time, in person-years, for each patients with s...

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    Conflict of Interest:
    None declared.