IN RANDOMIZED TRIALS OF ACUPUNCTURE

Considerable intellectual and practical effort has been expended on designing and evaluat-ing placebo controls in acupuncture studies. Somewhat less attention has been paid to the question: Why use a placebo in a randomized trial of acupuncture? This is partly because placebo controls have generally been seen as an inherent part of randomized trial method-ology. As a result, most acupuncture trials have included a placebo-control group. A large number of different placebo techniques have been used in these trials. The design and choice of placebo techniques has typically depended on purely theoretical consider-ations, without empirical validation of physi-ological inactivity and psychological credi-bility. Principles can be developed for deciding whether to use placebo or another form of control in a randomized trial. These include issues of ethics, practicality and meth-odology. Such principles apply regardless of the intervention; they can and should be applied to acupuncture research