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Methodological Issues in Trials of Acupuncture
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To the Editor: Dr Shen and colleagues1 found that acupuncture was efficacious in the treatment of chemotherapy-induced emesis. Such rigorous research is a welcome contribution to the often highly charged discussion of alternative therapies. Indeed, the authors' attempts to assess whether blinding was successful in their randomized controlled trial (RCT) represent a definite improvement over most earlier trials of acupuncture and emesis. Nonetheless, most of the previous trials did manage to blind patients to their treatment arm. In fact, a review of acupuncture-acupressure antiemesis trials found that sham control subjects were included in 7 of 21 RCTs of treatments for postoperative emesis, 2 of 5 trials of cancer chemotherapy–associated emesis and 7 of 8 RCTs of treatments for morning sickness.2
A more difficult problem in acupuncture trials has been to blind practitioners to the treatment being given. A few of the previous RCTs not only blinded the subject (and assessor), . . . [Full Text of this Article]
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