title: Does prior acupuncture exposure affect perception of blinded real or sham acupuncture?
abstract: OBJECTIVE
  To determine if acupuncture-exposed and naïve participants differ in their perceptions of real and sham acupuncture under blinded conditions.
  
  
  METHODS
  The setting was an outpatient clinic at the Colorado School of Traditional Chinese Medicine. Participants were between the ages of 18 and 90 years. Acupuncture-exposed participants had at least five prior acupuncture treatments, with one treatment in the month prior to the study date. Acupuncture-naïve participants had experienced no prior acupuncture treatments. Participants with dementia, cognitive impairment, or neuropathy were excluded. In total, 61 acupuncture-exposed and 59 acupuncture-naïve participants were blindfolded and received either real acupuncture or toothpick sham acupuncture treatment. Following treatment, participants completed a questionnaire rating the realness of the acupuncture and were asked how they made this determination. We used a previously developed scale rating treatments from 1 (definitely real needle) to 5 (definitely imitation needle) to assess outcome.
  
  
  RESULTS
  Perceptions of the real treatment were rated as more real than sham treatments for all participants. Further analysis revealed that prior acupuncture exposure did not influence ratings of real treatments, but exposed participants rated sham treatments as significantly less real than naïve participants.
  
  
  CONCLUSIONS
  Acupuncture-naïve and exposed participants both reported different perceptions of real and sham acupuncture using a blindfolded toothpick protocol. This suggests that future trials should carefully monitor participant perceptions of treatments received, even for naïve individuals. Differences between groups further suggest that participants with significant and/or recent exposure to real acupuncture may introduce bias to blinded clinical acupuncture trials.
authors.affiliation: Colorado School of Traditional Chinese Medicine, , Denver, Colorado, USA.
authors.forename: Caitlin R
authors.initials: CR
authors.lastname: Dilli
authors.forename: Rebecca
authors.initials: R
authors.lastname: Childs
authors.forename: Julie
authors.initials: J
authors.lastname: Berk
authors.forename: M K
authors.initials: MK
authors.lastname: Christian
authors.forename: Nancy
authors.initials: N
authors.lastname: Nguyen
authors.forename: R Preston
authors.initials: RP
authors.lastname: Brown
authors.forename: Benzi M
authors.initials: BM
authors.lastname: Kluger
mesh_terms: D015670:Acupuncture Therapy / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology; D010465:Perception; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Acupuncture; Statistics & Research Methods