title: Measuring expectations of benefit from treatment in acupuncture trials: a systematic review.
abstract: OBJECTIVE
  We conducted a systematic review that aimed to document and describe how (1) expectation of benefit from treatment (response expectancies) were measured and reported in acupuncture trials, and (2) examine any effect on outcomes.
  
  
  METHODS
  We searched MEDLINE, EMBASE, AMED, CIHAHL, CENTRAL and Science and Technology Proceedings up to November 2007 for randomised (RCT) and quasi-randomised (CCT) controlled trials and prospective controlled cohorts of acupuncture as treatment for a medical or psychological condition in adults. An update citation search was conducted in April 2010. We included studies that mentioned soliciting response expectancies.
  
  
  RESULTS
  We found 58 RCTs that fulfilled our inclusion criteria. Around half referenced one of five published instruments, most of which were designed to measure sham credibility and included one question on response expectancy. A wide range of question phrasing and response scales was used. There was some evidence that response scales may influence the measurement of expectations. Eight trials analysed the association between pre-randomisation expectations for assigned treatment and outcomes, and six the effect of pre-randomisation expectations across all patients independent of treatment allocation. Some showed associations but others did not.
  
  
  CONCLUSIONS
  There is some evidence that response expectancies interact with outcomes in acupuncture trials however the variety of question phrasing and analysis methods precludes drawing a firm conclusion about for whom and under which circumstance. To further our understanding of expectations, more methodological work is needed to standardise the questions and response scales that are used.
authors.affiliation: Department of Health Sciences, The University of York, Heslingtonm, York, UK. Electronic address: stephanie.prady@york.ac.uk.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Prady
authors.affiliation: Centre for Reviews and Dissemination, The University of York, Heslington, York, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Burch
authors.affiliation: Division of Population Health Sciences and Education, St. George's, University of London, London, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Vanderbloemen
authors.affiliation: Department of Health Sciences, The University of York, Heslingtonm, York, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Crouch
authors.affiliation: Department of Health Sciences, The University of York, Heslingtonm, York, UK.
authors.forename: Hugh
authors.initials: H
authors.lastname: MacPherson
mesh_terms: D015670:Acupuncture Therapy / Q000592:standards*; D023381:Endpoint Determination; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012107:Research Design; D016896:Treatment Outcome
keywords: Acupuncture; Clinical trials; Complex interventions; Measurement; Patient expectations; Psychometrics; Response expectancies