Proposed Standards of Acupuncture Treatment for Clinical Studies

Stux, Gabriel; Birch, Stephen

doi:10.1007/978-3-642-56732-2_10

Cited by 29 publications

(35 citation statements)

References 30 publications

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“…It thus appears that the control needle insertion conditions have been labeled "sham" entirely by fiat. Before large scale studies are conducted, preliminary studies should be conducted to estimate the degree of relative inactivity, and relative activity, of the control and active conditions [23].…”

Section: Reflections: Where Does the Research Stand?mentioning

confidence: 99%

Acupuncture for substance abuse

Margolin

2003

Curr Psychiatry Rep

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Acupuncture, in the form of insertion of needles bilaterally in the outer ears, is widely used for the treatment of addiction in the US. However, support for this form of treatment from controlled studies has not been consistent. This article examines recent clinical trials of acupuncture for addiction treatment, with a goal of conveying to the reader some of the complex issues involved in conducting studies in this area. Acupuncture trials in addictions frequently have been conducted without preliminary dose-ranging studies to establish efficacious doses of the experimental treatment, use needle insertion controls of unknown degrees of activity, and present no rationale for the type or intensity of concurrently offered psychotherapy. At the present time, it is premature to put forth recommendations for or against acupuncture for the treatment of addiction based on evidence from extant studies.

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Section: Reflections: Where Does the Research Stand?mentioning

confidence: 99%

Acupuncture for substance abuse

Margolin

2003

Curr Psychiatry Rep

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“…Recent efforts have been made to understand or assess aspects of what might constitute a quality acupuncture intervention. 6,[18][19][20] Despite this early work, the best method to assess quality of acupuncture remains undecided, and no clearly reliable tool has been developed. A recent Delphi study of expert opinion in Australia identified 28 items as essential components of quality acupuncture treatment.…”

Section: Introductionmentioning

confidence: 99%

Defining the Quality of Acupuncture

et al. 2015

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Background. The quality and dose of acupuncture used in a clinical trial affects the outcome, as with the quality and dose of any intervention. The dose of acupuncture treatment may be characterized by the frequency of treatment, needle type and depth, length of needle retention, point selection, and combination. The dose in trials of acupuncture has at times been described as low or inappropriate but is seldom assessed in systematic reviews of acupuncture trials. This article examines the research evaluating acupuncture for cancer-related fatigue to determine what characteristics of treatment may contribute to a quality acupuncture intervention. Methodology. English and Chinese language databases were searched from inception to December 2013 for randomized controlled trials of acupuncture for the treatment of cancer-related fatigue. Assessment of the quality of the acupuncture intervention was undertaken using the domains and items from the NICMAN framework. Results. Seven studies with a total of 690 patients were included. Four of the studies were designed as feasibility or pilot studies, and the other 3 studies were described as "effectiveness" trials. The treatment paradigm for the active intervention was based on traditional Chinese medicine in all studies, yet few of the studies were explicit as to how the active intervention was justified within a traditional Chinese medicine paradigm. Acupuncture point prescriptions were developed by a small consensus panel or based on typical points and/or "clinical experience." No discussion of traditional Chinese medicine theory or literature review was reported in any studies. Acupuncture point location was adequately described in 4 of the 7 studies. Frequency of treatment was twice per week in 2 studies; all others were once per week. Two studies did not apply needle manipulation or stimulation, and no justification was given. Conclusion. The 7 trials reviewed meet some criteria for a quality acupuncture intervention. However, frequently elements of the intervention were not addressed, and it is possible that the dosage trialed was suboptimal. Systematic reviews of acupuncture are likely to continue to be inconclusive while comparisons are conducted of heterogeneous interventions without providing.

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“…The German Acupuncture Trials (GERAC) showed acupuncture to be as effective as or more effective than standard therapy for osteoarthritis, low back pain and migraine, as well as for shoulder pain (German Randomized Acupuncture Trial for Shoulder Pain -GRASP), but found no meaningful difference between treatment that involved inserting needles into acupuncture points (verum) and that in which the needles were inserted into non-specific points (sham) (Diener et al, 2006;Scharf et al, 2006;Haake et al, 2007). Textbooks describe acupuncture points as having a spatial resolution of several millimetres, and expert acupuncture physicians insist on the importance of precise location of acupuncture points (Xinnong, 1987;Xie, 1994;Stux and Birch, 2001). As a result, clinical trials are often designed in such a way that non-specific or sham points are located only a few centimetres away from what are considered real or verum acupuncture points.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture points are large fields: The fuzziness of acupuncture point localization by doctors in practice

Molsberger

Manickavasagan

Abholz

et al. 2012

European Journal of Pain

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BackgroundAcupuncture textbooks, schools, practitioners and clinical researchers designing randomized controlled trials on acupuncture all assume that acupuncture points are small and must be located precisely.MethodSeventy‐one medical doctors with ≥200 h acupuncture training and ≥2 years of clinical experience independently identified 23 commonly used acupuncture points on a male volunteer, using sticky transparent films with an X/Y grid placed asymmetrically around acupuncture points.ResultsFor each acupuncture point, the field covering 95% (68%) of all point locations varied from 2.7 (0.7) cm2 for PC‐6 up to 41.4 (10.2) cm2 for ST‐38. Commonly‐used acupuncture points showed unexpectedly large variance in location: 95% (or 68%) areas were SP‐6: 12.2 cm2 (3.0 cm2), ST‐36: 20.7 cm2 (5.1 cm2), LI‐15: 18.7 cm2 (4.6 cm2), BL‐23: 22.4 cm2 (5.6 cm2) and BL‐54: 22.5 cm2 (5.6 cm2). Points close to anatomical landmarks (forearm, ankle, poplitea; BL‐60, BL‐40, TW‐5, PC‐6) were located with less variance. Precision of point location was independent of length of acupuncture experience, kind of training or medical specialty.ConclusionsIn respect to the high degree of variation in the localization of acupuncture points, we suggest that the term ‘acupuncture field’ is more appropriate than ‘acupuncture points’ to describe the clinical reality; for the design of sham‐controlled acupuncture trials, we recommend a minimum distance of 6 cm between verum and sham points on face, hands and feet, and up to 12 cm for all other parts of the body.

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Proposed Standards of Acupuncture Treatment for Clinical Studies

Cited by 29 publications

References 30 publications

Acupuncture for substance abuse

Acupuncture for substance abuse

Defining the Quality of Acupuncture

Acupuncture points are large fields: The fuzziness of acupuncture point localization by doctors in practice

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