There are two major problems in acupuncture research these days, both of which impact the results of this study.
First, while it is of interest that both real and sham acupuncture outperformed biomedical tx, there is always a potential confounder in this type of research design: When patients are attracted to a study by the possibility of receiving acupuncture but become randomized to the usual (biomedical) care group, this group may experience a disappointment effect (nocebo) that contributes to decreased effectiveness of tx.
Second, while varying forms of sham acupuncture continue to be used in clinical trials, the assumption in designing a sham procedure is that we know how the real tx ‘works’. (For example, a sham/placebo has credibility in a drug trial because we know how the drug works and can thus design a placebo that does not mimic the physiological effects of the drug.) Since we don’t know how acupuncture works, all we can mimic is one aspect of tx, i.e. what the patient sees, but this is an insufficient sham since we don’t know enough about the other aspect of tx - the physiological events that acupuncture initiates. Lacking this understanding, we don’t know what the sham tx should avoid.
Hope this is helpful. (As a researcher, my position is that if I don’t agree with – or find fault with - the study design, I don’t place much credence in the results, be they positive or negative.)
Richard Hammerschlag, PhD
Dean of Research
Oregon College of Oriental Medicine