Reliability of the NICMAN Scale: An Instrument to Assess the Quality of Acupuncture Administered in Clinical Trials

Table 1

Kappa statistic and intraclass correlation coefficient for all participants rating two papers.

Items	Paper 1 kappa statistic	Paper 2 kappa statistic
(1) Clearly described population	0.66	0.85
(2) Clearly described intervention	0.92	0.79
(3) Clearly described comparator	0.85	0.85
(4) Clearly described outcome	0.92	0.68
(5) Study design appropriate to question	0.72	0.73
(6a) Differential diagnosis (if undertaken) is stated	0.37	0.25
(6b) The practitioner undertaking the differential diagnosis is adequately trained, for example, registered with a regulatory authority, or meets at least the minimum WHO standard	0.35	0.60
(7a) Acupuncture points are selected according to the diagnosis in item (6)	0.40	0.32
(7b) The rationale for the acupuncture points is sourced from expert opinion, literature review, or text books	0.42	0.42
(8) Point location is described in published standard acupuncture location texts used as a reference, or location described in anatomical terms and/or an accurate proportional method for locating acupoints is used	0.31	0.92
(9a) Needle brand and dimension are used consistently across all participants and sessions	1.00	0.31
(9b) Depth of needle insertion is reported and referenced to a standard text or mm or range is stated	0.52	0.46
(9c) Manual needle manipulation is justified (in the absence of needle manipulation justification is provided for the decision not to undertake needle manipulation). If applicable, electroacupuncture device should be identified and approved in country of use	0.51	0.31
(9d) Needle sensation was sought and described	1.00	0.37
(10) If it is a chronic condition a minimum of six treatments are administered; if fewer treatments are delivered appropriate justification is documented	0.92	0.78
(11) The acupuncturist administering the intervention is registered with a regulatory authority or meets at least the minimum WHO standard	0.47	0.41
ICC for overall agreement (95% CI) excluding items (6a) and (6b)	0.46; (0.19 to 0.70)	0.55; (0.32 to 0.75)

For paper 1, see [10]; for paper 2, see [11].