What is lost in the acupuncture trial when using a sham intervention?

Controversy still surrounds the evaluation of acupuncture’s effectiveness as a therapeutic intervention in the era of evidence-based medicine, and this is exemplified by published clinical research on acupuncture for menopausal hot flushes among climacteric women. Ee et al1 conducted a randomised control trial (RCT) in patients experiencing hot flushes who were mainly acupuncture-naïve Caucasian women in Australia. Patients were randomised to receive 10 treatment sessions of either verum acupuncture, which involved needle insertion at six classical acupuncture points, or sham acupuncture, which involved stimulation at six non-acupuncture sham points with sham devices, over the course of 8 weeks. It was demonstrated that both interventions improved the hot flush score (the primary outcome of this study) by approximately 40% relative to baseline, and that the improvement continued up to 6 months following the end of treatment in both groups with no statistically significant difference between the two arms. Soon...

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