Evidence map›Paper›PMID 19183454›Full record

ArticleChinese medicine2009

Minimal acupuncture is not a valid placebo control in randomised controlled trials of acupuncture: a physiologist's perspective.

Iréne Lund, Jan Näslund, Thomas Lundeberg

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Chinese medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 95 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
95citing papers in PubMed, 15 pooled it
48.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

95 citing papers in PubMed, 15 syntheses or guidelines pooled it, 219 citations in OpenAlex.

  1. Pooled it
  2. Acupuncture for Chronic Pain Management in Haemophilic Arthropathy: A Systematic Review.Haemophilia : the official journal of the World Federation of Hemophilia · 2025
    Pooled it
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  4. A systematic review of sham acupuncture validation studies.BMC complementary medicine and therapies · 2024
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  11. Acupuncture for cancer pain in adults.The Cochrane database of systematic reviews · 2015
    Pooled it
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  13. Acupuncture and related interventions for smoking cessation.The Cochrane database of systematic reviews · 2014
    Pooled it
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35 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Iréne LundDepartment of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden. Irene.Lund@ki.se
Jan Näslund
Thomas Lundeberg
Karolinska Institutet · SESabbatsberg Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Placebo-control of acupuncture is used to evaluate and distinguish between the specific effects and the non-specific ones. During 'true' acupuncture treatment in general, the needles are inserted into acupoints and stimulated until deqi is evoked. In contrast, during placebo acupuncture, the needles are inserted into non-acupoints and/or superficially (so-called minimal acupuncture). A sham acupuncture needle with a blunt tip may be used in placebo acupuncture. Both minimal acupuncture and the placebo acupuncture with the sham acupuncture needle touching the skin would evoke activity in cutaneous afferent nerves. This afferent nerve activity has pronounced effects on the functional connectivity in the brain resulting in a 'limbic touch response'. Clinical studies showed that both acupuncture and minimal acupuncture procedures induced significant alleviation of migraine and that both procedures were equally effective. In other conditions such as low back pain and knee osteoarthritis, acupuncture was found to be more potent than minimal acupuncture and conventional non-acupuncture treatment. It is probable that the responses to 'true' acupuncture and minimal acupuncture are dependent on the aetiology of the pain. Furthermore, patients and healthy individuals may have different responses. In this paper, we argue that minimal acupuncture is not valid as an inert placebo-control despite its conceptual brilliance.

Identifiers

PMID19183454
PMCPMC2644695
OpenAlexW1992309933

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.