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Evidence-Based Complementary and Alternative Medicine
Volume 2012, Article ID 857804, 12 pages
http://dx.doi.org/10.1155/2012/857804
Review Article

A Systematic Review of the Effect of Expectancy on Treatment Responses to Acupuncture

1Centre for Complementary Medicine Research, University of Western Sydney, NSW 2751, Australia
2School of Psychology, University of New South Wales, Kensington, NSW 2052, Australia

Received 25 May 2011; Revised 9 August 2011; Accepted 6 September 2011

Academic Editor: David Baxter

Copyright © 2012 Ben Colagiuri and Caroline A. Smith. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Randomised controlled trials (RCTs) of acupuncture often find equivalent responses to real and placebo acupuncture despite both appearing superior to no treatment. This raises questions regarding the mechanisms of acupuncture, especially the contribution of patient expectancies. We systematically reviewed previous research assessing the relationship between expectancy and treatment responses following acupuncture, whether real or placebo. To be included, studies needed to assess and/or manipulate expectancies about acupuncture and relate these to at least one health-relevant outcome. Nine such independent studies were identified through systematic searches of Medline, PsycInfo, PubMed, and Cochrane Clinical Trials Register. The methodology and reporting of these studies were quite heterogeneous, meaning that meta-analysis was not possible. A descriptive review revealed that five studies found statistically significant effects of expectancy on a least one outcome, with three also finding evidence suggestive of an interaction between expectancy and type of acupuncture (real or placebo). While there were some trends in significant effects in terms of study characteristics, their generality is limited by the heterogeneity of study designs. The differences in design across studies highlight some important methodological considerations for future research in this area, particularly regarding whether to assess or manipulate expectancies and how best to assess expectancies.