The acupuncture randomised trial (ART) for tension-type headache--details of the treatment.
OBJECTIVE
The goal of this paper is to describe the characteristics of physicians and their interventions in a large, multicentre randomised trial of acupuncture for tension-type headache known as ART TTH, in order to enable acupuncturists to assess the study interventions.


METHODS
Participating physicians were recruited whose qualifications met or surpassed those of physicians currently accredited for providing acupuncture by state health funding agencies in Germany. Semi-standardised treatment strategies for acupuncture and minimal acupuncture were developed in a consensus process with acupuncture experts. A total of 270 patients suffering from episodic or chronic tension-type headache were randomised to 12 sessions of semi-standardised acupuncture (three predefined 'basic' points, recommendations for additional points given, but individual choice of additional points possible), standardised minimal acupuncture (superficial needling of at least 5 of 10 predefined, bilateral, distant non-acupuncture points) or a waiting list. Forty two physicians, trained and experienced in acupuncture, from 28 centres in Germany participated in the trial.


RESULTS
The median duration of acupuncture training of trial physicians was 500 hours (range 140 to 1350 hours). Physicians had 10 (< 1 to 25) years acupuncture experience. The three 'basic' points (GB20, GB21 and LR3) were treated in 96%, 82% and 97% of sessions, respectively. Frequently treated optional points included LI4 (67%), SP6 (50%) and ST36 (46%). Ten of the 42 physicians stated that they would have treated patients differently outside the trial. The trial found a significant effect of acupuncture over waiting list but not over minimal acupuncture.


CONCLUSIONS
In general, trial physicians complied well with the predefined interventions. A relevant minority of participating trial physicians stated that they would have treated patients differently outside the trial.
Melchart
Dieter
D
Centre for Complementary Medicine Research, Technische Universität München, Munich, Germany.
Streng
Andrea
A
Hoppe
Andrea
A
Brinkhaus
Benno
B
Becker-Witt
Claudia
C
Hammes
Michael
M
Irnich
Dominic
D
Hummelsberger
Josef
J
Willich
Stefan N
SN
Linde
Klaus
K
D026881:Acupuncture / Q000193:education; D015670:Acupuncture Therapy / Q000379:methods*; D000328:Adult; D000368:Aged; D004502:Education, Medical, Continuing; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic / Q000379:methods*; D010147:Pain Measurement; D010349:Patient Compliance / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D011795:Surveys and Questionnaires; D018781:Tension-Type Headache / Q000628:therapy*; D016896:Treatment Outcome