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Evidence-Based Complementary and Alternative Medicine
Volume 2013, Article ID 708251, 12 pages
Review Article

Blinding Measured: A Systematic Review of Randomized Controlled Trials of Acupuncture

1The Center for Musculoskeletal Care and Department of Rehabilitation Medicine, New York University School of Medicine, 333 East 38th Street, 5th Floor, Room 5-103, New York, NY 10016, USA
2Department of Neuroscience, Brown University, Providence, RI 02912, USA
3Division of Biostatistics, Department of Public Health Sciences, University of California-Davis, Davis, CA 95616, USA
4Asian Medicine and Acupuncture Research, Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC 27514, USA
5Orofacial Pain Program, Regional Center for Neurosensory Disorders, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, USA

Received 17 October 2012; Revised 6 January 2013; Accepted 6 January 2013

Academic Editor: Gerhard Litscher

Copyright © 2013 Alex Moroz et al. 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.


Background. There is no agreement among researchers on viable controls for acupuncture treatment, and the assessment of the effectiveness of blinding and its interpretation is rare. Purpose. To systematically assess the effectiveness of blinding (EOB) in reported acupuncture trials; to explore results of RCTs using a quantitative measure of EOB. Data Sources. A systematic review of published sham RCTs that assessed blinding. Study Selection. Five hundred and ninety studies were reviewed, and 54 studies (4783 subjects) were included. Data Extraction. The number of patients who guessed their treatment identity was extracted from each study. Variables with possible influence on blinding were identified. Data Synthesis. The blinding index was calculated for each study. Based on blinding indexes, studies were congregated into one of the nine blinding scenarios. Individual study characteristics were explored for potential association with EOB. Limitations. There is a possibility of publication or reporting bias. Conclusions. The most common scenario was that the subjects believed they received verum acupuncture regardless of the actual treatment received, and overall the subject blinding in the acupuncture studies was satisfactory, with 61% of study participants maintaining ideal blinding. Objectively calculated blinding data may offer meaningful and systematic ways to further interpret the findings of RCTs.