title: Selecting acupuncture treatment for hot flashes: a Delphi consensus compared with a clinical trial.
abstract: OBJECTIVE
  A treatment protocol was required for a trial of traditional Chinese acupuncture for menopausal hot flashes (ACUFLASH). A study that aimed to generate a consensus of the opinions of expert practitioners was set up, though the trial commenced before the process had been completed. This article reports on the consensus process, and compares the syndromes and treatments generated by expert consensus with those actually used in the clinical trial.
  
  
  METHODS
  A panel of 10 experts was included in an e-mail Delphi process. The experts were asked to suggest the syndromes they would expect to be diagnosed most frequently in women with menopausal hot flashes. They were asked to list the symptoms they would use to diagnose the individual syndromes, and the points they would use to treat them.
  
  
  RESULTS
  After six rounds of the Delphi process, consensus was achieved on eight syndromes, and on about five indicative symptoms for each syndrome, and five to eight acupuncture points for treatment. The clinicians in the ACUFLASH trial used five syndromes, four of which matched the consensus. The points used by the two groups overlapped by 28%.
  
  
  CONCLUSIONS
  Eight (8) of 10 international acupuncture experts were able to reach consensus on the syndromes, symptoms, and treatment of postmenopausal women with hot flashes. The syndromes were similar to those used by practitioners in the ACUFLASH clinical trial, but there were considerable differences between the acupuncture points. This difference is likely to be the result of differences in approach of training schools, and whether it is relevant for clinical outcomes is not well understood.
authors.affiliation: The National Research Center in Complementary and Alternative Medicine, University of Tromsø, Tromsø, Norway. terje.alrak@.uit.no
authors.forename: Terje
authors.initials: T
authors.lastname: Alraek
authors.forename: Einar
authors.initials: E
authors.lastname: Borud
authors.forename: Adrian
authors.initials: A
authors.lastname: White
mesh_terms: D015669:Acupuncture Points; D015670:Acupuncture Therapy / Q000379:methods*; D002986:Clinical Trials as Topic; D003697:Delphi Technique; D003937:Diagnosis, Differential; D005260:Female; D019584:Hot Flashes / Q000628:therapy*; D006801:Humans; D013577:Syndrome