Proposed Standards of Acupuncture Treatment for Clinical Studies

Abstract

The quality of clinical trials of acupuncture conducted since the early 1970s is often poor. General reviews and formal evaluations of the literature are uniform in this finding [22, 23, 26, 27, 30, 32, 34, 37--39, 43, 51, 53, 55, 59, 66, 67, 70--74]. While the literature evaluating these clinical trials continues to grow, it has focused largely on the methodological quality of the study designs and the soundness of their results, but there has been little discussion of the adequacy of the acupuncture treatment itself. A few authors have suggested that the quality or adequacy of the acupuncture in these clinical trials may be problematic [17, 32, 57, 63], and some have discussed guidelines to suggest what constitutes adequate treatment [4, 64]. There is generally a paucity of systematic analysis of the adequacy of the acupuncture tested in these clinical trials. One review team merely assessed whether the treatment was reported or not [34, 66, 67]. Another team attempted to develop criteria for such an evaluation but experienced difficulties with the method selected [39]. This essay will outline criteria for evaluating the adequacy of treatment in acupuncture studies, present evaluations of the adequacy of a number of clinical trials, and describe a systematic method for ensuring adequacy in future studies. Preliminary versions of some of these methods and data have been presented in previous research conferences and publications [4--6, 23, 64].