title: The Effectiveness of Individualized Acupuncture Protocols in the Treatment of Gulf War Illness: A Pragmatic Randomized Clinical Trial.
abstract: BACKGROUND
  Gulf War Illness is a Complex Medical Illness characterized by multiple symptoms, including fatigue, sleep and mood disturbances, cognitive dysfunction, and musculoskeletal pain affecting veterans of the first Gulf War. No standard of care treatment exists.
  
  
  METHODS
  This pragmatic Randomized Clinical Trial tested the effects of individualized acupuncture treatments offered in extant acupuncture practices in the community; practitioners had at least 5 years of experience plus additional training provided by the study. Veterans with diagnosed symptoms of Gulf War Illness were randomized to either six months of biweekly acupuncture treatments (group 1, n = 52) or 2 months of waitlist followed by weekly acupuncture treatments (group 2, n = 52). Measurements were taken at baseline, 2, 4 and 6 months. The primary outcome is the SF-36 physical component scale score (SF-36P) and the secondary outcome is the McGill Pain scale.
  
  
  RESULTS
  Of the 104 subjects who underwent randomization, 85 completed the protocol (82%). A clinically and statistically significant average improvement of 9.4 points (p = 0.03) in the SF-36P was observed for group 1 at month 6 compared to group 2, adjusting for baseline pain. The secondary outcome of McGill pain index produced similar results; at 6 months, group 1 was estimated to experience a reduction of approximately 3.6 points (p = 0.04) compared to group 2.
  
  
  CONCLUSIONS
  Individualized acupuncture treatment of sufficient dose appears to offer significant relief of physical disability and pain for veterans with Gulf War Illness. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Gulf War Illness Research Program under Award No. W81XWH-09-2-0064. Opinions, interpretations, conclusions and recommendations are those of the author and are not necessarily endorsed by the Department of Defense.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01305811.
authors.affiliation: New England School of Acupuncture, Newton, MA, United States of America.
authors.forename: Lisa
authors.initials: L
authors.lastname: Conboy
authors.affiliation: Department of Epidemiology, College of Medicine and College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States of America.
authors.forename: Travis
authors.initials: T
authors.lastname: Gerke
authors.affiliation: New England School of Acupuncture, Newton, MA, United States of America.
authors.forename: Kai-Yin
authors.initials: KY
authors.lastname: Hsu
authors.affiliation: New England School of Acupuncture, Newton, MA, United States of America.
authors.forename: Meredith
authors.initials: M
authors.lastname: St John
authors.affiliation: Boston Veterans Healthcare System/Jamaica Plain Campus, Boston, MA, United States of America.
authors.forename: Marc
authors.initials: M
authors.lastname: Goldstein
authors.affiliation: University of Texas at Austin, Austin, TX, United States of America.
authors.forename: Rosa
authors.initials: R
authors.lastname: Schnyer
mesh_terms: D015670:Acupuncture Therapy; D003198:Computer Simulation; D016001:Confidence Intervals; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010147:Pain Measurement; D018923:Persian Gulf Syndrome / Q000628:therapy*; D057285:Precision Medicine; D011795:Surveys and Questionnaires; D016896:Treatment Outcome