Introducing a placebo needle into acupuncture research

Streitberger, Konrad; J, Kleinhenz

doi:10.1016/s0140-6736(97)10471-8

Cited by 805 publications

(602 citation statements)

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“…In the other RCT that found large, clinically relevant benefits of acupuncture (46), the sham needles did not penetrate the skin. Although some shams with nonpenetrating needles have demonstrated credibility among acupuncturenaive patients (55), the credibility of the sham in the RCT (46) was not tested among the acupuncture-naive patients. Thus, we cannot be certain that this nonpenetrating needle sham was believable for all patients.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis: Acupuncture for Osteoarthritis of the Knee

et al. 2007

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Section: Discussionmentioning

confidence: 99%

Meta-analysis: Acupuncture for Osteoarthritis of the Knee

et al. 2007

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“…Sham / placebo acupuncture administration-Placebo treatment used a validated sham acupuncture needle (Streitberger placebo) [16,17,19,28,31,37,40] and was identical to active manual acupuncture except that the needle was not inserted into the skin and the acupuncturist held and rotated the needle more gently. The sham needles differed from regular needles by possessing blunt and retractable tips.…”

Section: Acupuncture Administrationmentioning

confidence: 99%

A combined [11C]diprenorphine PET study and fMRI study of acupuncture analgesia

Dougherty

Kong

Webb

et al. 2008

Behavioural Brain Research

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Functional neuroimaging studies suggest that a lateral network in the brain is associated with the sensory aspects of pain perception while a medial network is associated with affective aspects. The highest concentration of opioid receptors is in the medial network. There is significant evidence that endogenous opioids are central to the experience of pain and analgesia. We applied an integrative multimodal imaging approach during acupuncture. We found functional magnetic resonance imaging signal changes in the orbitofrontal cortex, insula, and pons and [11C]diprenorphine positron emission tomography signal changes in the orbitofrontal cortex, medial prefrontal cortex, insula, thalamus, and anterior cingulate cortex. These findings include brain regions within both the lateral and medial pain networks.

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“…[3][4][5] Studies examining the blinding effectiveness of the sham devices usually investigate similarities between the sensory intensities elicited by the sham and real needles that are felt by the participants. 1 If the sensory intensities to both needle types are not statistically different from each other, then it is indirectly inferred that the sham device is capable of blinding the participant. However, Takakura and Yajima 6 commented that the presence of a needle penetration sensation was not indicative of whether the participants believed a real needle was administered.…”

mentioning

confidence: 99%

“…7 The true positive rate and false positive rate are analogous to the outcome measures of sensitivity and 1-specificity, respectively, in the study of diagnostic accuracy. 8 To obtain d=, the true positive rate is subtracted from the false positive rate and then 1,9 Multiple acupoints, which may include both traditional and nontraditional acupoints, should ideally be used to simulate clinical practice better. Second, previous studies have also used between-groups designs to compare real and sham needle discrimination using the sham devices.…”

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confidence: 99%

Discrimination of Real and Sham Acupuncture Needles Using the Park Sham Device: A Preliminary Study

Tan

Christie²,

St-Georges

et al. 2009

Archives of Physical Medicine and Rehabilitation

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This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. Objective: To evaluate the blinding effectiveness of the Park sham acupuncture device using participants' ability to discriminate between the real and sham acupuncture needles.Design: The design was a yes-no experiment. Judgments were made on whether the real or sham acupuncture needle was administered.Setting: University laboratory. Participants: Healthy, acupuncture-naive university students and staff (Nϭ20; median age, 22y; range, 18 -48y) recruited through convenience sampling.Interventions: Participants made yes-no judgments on whether the real or sham needle was administered to 8 acupoints (4 traditional and 4 nontraditional) along the Pericardium meridian (Pericardium 3 to Pericardium 6) on the dominant forearm.Main Outcome Measures: The accuracy index, d=, of participants' ability to discriminate between the real and sham needles (discriminability) was computed for the traditional alone, the nontraditional alone, and a combination of both types of acupoints.Results: The participants' d= between the real and sham needles was not statistically significant from d= equal to 0 for the combined traditional and nontraditional acupoints comparison and the nontraditional acupoints alone comparison (combined, t 19 ϭ1.20, Pϭ.25; nontraditional, t 19 ϭ.16, Pϭ.87). However, the participants' d= was statistically significant from d= equal to 0 for the traditional acupoints comparison (t 19 ϭ2.096, Pϭ.049).Conclusions: The Park sham acupuncture device appears to be effective in blinding participants to real acupuncture intervention when it is applied to the nontraditional acupoints and when traditional and nontraditional acupoints are combined on the forearm along the pericardium meridian. However, the sham device does not appear to blind participants effectively when traditional acupoints alone are used for the same context.

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Introducing a placebo needle into acupuncture research

Cited by 805 publications

References 12 publications

Meta-analysis: Acupuncture for Osteoarthritis of the Knee

Meta-analysis: Acupuncture for Osteoarthritis of the Knee

A combined [11C]diprenorphine PET study and fMRI study of acupuncture analgesia

Discrimination of Real and Sham Acupuncture Needles Using the Park Sham Device: A Preliminary Study

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