Redefining the randomized controlled trial in the context of acupuncture research.
BACKGROUND
The randomized controlled trial (RCT) is considered the 'gold standard' methodology for evaluating efficacy of an intervention. It has been argued that RCTs cannot be used to examine the effectiveness of acupuncture.


OBJECTIVE
The purpose of this paper is to examine the applicability of an RCT study design for acupuncture research.


RESULTS
RCTs would be more effective in studying acupuncture if study participants were randomized to groups based on the acupuncture diagnosis and not solely on the Western diagnostic criteria. Treatments must also be standardized somewhat to ensure replicability of the study and the information it provides. Blinding is not absolutely necessary for a good-quality RCT; however, if used, control groups need to be standardized and sham techniques evaluated to ensure accurate interpretation of results.


CONCLUSIONS
With these factors combined, it is possible to greatly increase internal and external validity in acupuncture RCTs.
Walji
Rishma
R
Leslie Dan Faculty of Pharmacy, University of Toronto, 19 Russell Street, Toronto, Ont., Canada. rishma.walji@utoronto.ca
Boon
Heather
H
D015670:Acupuncture Therapy / Q000592:standards; D015982:Bias; D035061:Control Groups; D019317:Evidence-Based Medicine / Q000592:standards; D017408:Guidelines as Topic; D006801:Humans; D018579:Patient Selection; D010919:Placebos; D016032:Randomized Controlled Trials as Topic / Q000592:standards*; D015203:Reproducibility of Results; D012107:Research Design / Q000592:standards*; D016037:Single-Blind Method; D016896:Treatment Outcome
D010919:Placebos