Controlling for non-specific effects of acupuncture in clinical trials

Placebo controlled trials are used to examine the relative size of the specific effects of a therapy. When the therapy is a manual treatment like acupuncture, placebo control models are very complex due to the range of non-specific effects that can occur and issues such as blinding. This article examines ten different research models that have been used to control for placebo or other non-specific effects in clinical trials of acupuncture. Through an examination of the different non-specific effects that can occur in acupuncture therapy, it explores the relative ability of these ten models to control for the placebo and other non-specific effects. Three models are eliminated as probably unable to adequately control for these effects and therefore unable to explore the specific effects of acupuncture. The strengths and weaknesses of the remaining seven models are analyzed. Finally, methods and assessments needed to control for non-specific effects are discussed so that these seven models can be used to control for these effects and thus the models can examine the specific effects of acupuncture treatment.