ZHOU Hang,WANG Liqiong,TU Jianfeng,et al.Current Situation and Methodological Reflections on Blinding Assessment in Randomised Controlled Trials of Acupuncture[J].Journal of Traditional Chinese Medicine,2024,65(19):1978-1982.
ZHOU Hang,WANG Liqiong,TU Jianfeng,et al.Current Situation and Methodological Reflections on Blinding Assessment in Randomised Controlled Trials of Acupuncture[J].Journal of Traditional Chinese Medicine,2024,65(19):1978-1982.DOI: 10.13288/j.11-2166/r.2024.19.005.
Current Situation and Methodological Reflections on Blinding Assessment in Randomised Controlled Trials of Acupuncture
Blinding is an important means to control and reduce measurement bias in clinical research, and blinding assessment is the main method to measure the success of the blinding method. By summarizing the current situation of blinding assessment in randomized controlled trials (RCT) of acupuncture, it was found that the report rate of blinding assessment by acupuncture RCT was relatively low, and the studies reporting blinding assessment had several problems, such as incomplete assessment individuals, unreasonable assessment questionnaires, and unscientific analysis methods, and the setting of the assessment time point is controversial. Given the above problems, this paper discussed the key elements of blinding assessment individuals, assessment questionnaires, assessment time points, and analysis methods. It is suggested that blinding assessment should be carried out on all blinded participants and personnel in the study; the assessment questionnaire should be designed by direct inquiry, with responses designed using three or more categorical options that include an "unclear" option; the early stage of the trial should be taken as the mandatory time point for assessment, integrating the evaluation index of the James blinding index and the Bang blinding index, in order to standardize the application of blinding assessment in acupuncture RCT and improve the quality of acupuncture clinical research.
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SCHULZ KF , GRIMES DA . Blinding in randomised trials: hiding who got what [J]. Lancet , 2002 , 359 ( 9307 ): 696 - 700 .
JüNI P , ALTMAN DG , EGGER M . Systematic reviews in health care: Assessing the quality of controlled clinical trials [J]. BMJ , 2001 , 323 ( 7303 ): 42 - 46 .
SACKETT DL . Commentary: measuring the success of blinding in RCTs: don't, must, can't or needn't? [J]. Int J Epidemiol , 2007 , 36 ( 3 ): 664 - 665 .
CHAE Y , LEE YS , ENCK P . How placebo needles differ from placebo pills? [J]. Front Psychiatry , 2018 , 9 : 243 . doi: 10.3389/fpsyt.2018.00243 http://dx.doi.org/10.3389/fpsyt.2018.00243 .
MOROZ A , FREED B , TIEDEMANN L , et al . Blinding measured: a systematic review of randomized controlled trials of acupuncture [J]. Evid Based Complement Alternat Med , 2013 , 2013 : 708251 . doi: 10.1155/2013/708251 http://dx.doi.org/10.1155/2013/708251 .
LEE YS , KIM SY , KIM M , et al . Reporting quality of sham needles used as controls in acupuncture trials: a methodological evaluation [J]. Chin Med , 2022 , 17 ( 1 ): 64 .
XIE Y , LIU X , LIU T , et al . Descriptions of sham acupuncture in randomised controlled trials: a critical review of the literature [J]. BMC Complement Med Ther , 2023 , 23 ( 1 ): 173 .
DAY SJ , ALTMAN DG . Statistics notes: blinding in clinical trials and other studies [J]. BMJ , 2000 , 321 ( 7259 ): 504 .
ZHANG GS , ZHANG CS , TAN HY , et al . Systematic review of acupuncture placebo devices with a focus on the credibility of blinding of healthy participants and/or acupuncturists [J]. Acupunct Med , 2018 , 36 ( 4 ): 204 - 214 .
TAKAKURA N , YAJIMA H . A double-blind placebo needle for acupuncture research [J]. BMC Complement Altern Med , 2007 , 7 : 31 . doi: 10.1186/1472-6882-7-31 http://dx.doi.org/10.1186/1472-6882-7-31 .
KIM TH , LEE MS , ALRAEK T , et al . Acupuncture in sham device controlled trials may not be as effective as acupuncture in the real world: a preliminary network meta-analysis of studies of acupuncture for hot flashes in menopausal women [J]. Acupunct Med , 2020 , 38 ( 1 ): 37 - 44 .
SCHULZ KF , CHALMERS I , ALTMAN DG . The landscape and lexicon of blinding in randomized trials [J]. Ann Intern Med , 2002 , 136 ( 3 ): 254 - 259 .
NOSEWORTHY JH , EBERS GC , VANDERVOORT MK , et al . The impact of blinding on the results of a randomized, placebo-controlled multiple sclerosis clinical trial [J]. Neurology , 1994 , 44 ( 1 ): 16 - 20 .
TU JF , YANG JW , SHI GX , et al . Efficacy of intensive acupuncture versus Sham acupuncture in knee osteoarthritis: a randomized controlled trial [J]. Arthritis Rheumatol , 2021 , 73 ( 3 ): 448 - 458 .
INOUE M , KITAKOJI H , ISHIZAKI N , et al . Relief of low back pain immediately after acupuncture treatment:a randomised, placebo controlled trial [J]. Acupunct Med , 2006 , 24 ( 3 ): 103 - 108 .
KERR DP , WALSH DM , BAXTER D . Acupuncture in the management of chronic low back pain: a blinded randomized controlled trial [J]. Clin J Pain , 2003 , 19 ( 6 ): 364 - 370 .
REES JR , WADE TJ , LEVY DA , et al . Changes in beliefs identify unblinding in randomized controlled trials: a method to meet CONSORT guidelines [J]. Contemp Clin Trials , 2005 , 26 ( 1 ): 25 - 37 .
SHIN S , YANG SP , YU A , et al . Effectiveness and safety of electroacupuncture for poststroke patients with shoulder pain: study protocol for a double-center, randomized, patient- and assessor-blinded, sham-controlled, parallel, clinical trial [J]. BMC Complement Altern Med , 2019 , 19 ( 1 ): 58 .
XU JJ , REN M , ZHAO JJ , et al . Effectiveness of theta and gamma electroacupuncture for post-stroke patients on working memory and electrophysiology: study protocol for a double-center, randomized, patient- and assessor-blinded, sham-controlled, parallel, clinical trial [J]. Trials , 2020 , 21 ( 1 ): 910 .
KOLAHI J , BANG H , PARK J . Towards a proposal for assessment of blinding success in clinical trials: up-to-date review [J]. Community Dent Oral Epidemiol , 2009 , 37 ( 6 ): 477 - 484 .
BOUTRON I , ESTELLAT C , RAVAUD P . A review of blinding in randomized controlled trials found results inconsistent and questionable [J]. J Clin Epidemiol , 2005 , 58 ( 12 ): 1220 - 1226 .
HOPTON AK , MACPHERSON H . Assessing blinding in randomised controlled trials of acupuncture: challenges and recommendations [J]. Chin J Integr Med , 2011 , 17 ( 3 ): 173 - 176 .
SACKETT DL . Turning a blind eye: why we don't test for blindness at the end of our trials [J]. BMJ , 2004 , 328 ( 7448 ): 1136 .
JAMES KE , BLOCH DA , LEE KK , et al . An index for assessing blindness in a multi-centre clinical trial: disulfiram for alcohol cessation-a VA cooperative study [J]. Stat Med , 1996 , 15 ( 13 ): 1421 - 1434 .
BANG H , NI L , DAVIS CE . Assessment of blinding in clinical trials [J]. Control Clin Trials , 2004 , 25 ( 2 ): 143 - 156 .
ARANDJELOVIC O . Assessing blinding in clinical trials [C]. Advances in Neural Information Processing Systems (NIPS) , 2012 : 530 - 538 . https://proceedings.neurips.cc/paper_files/paper/2012/file/d6baf65e0b240ce177cf70da146c8dc8-Paper.pdf https://proceedings.neurips.cc/paper_files/paper/2012/file/d6baf65e0b240ce177cf70da146c8dc8-Paper.pdf .
BANG H . Random guess and wishful thinking are the best blinding scenarios [J]. Contemp Clin Trials Commun , 2016 , 3 : 117 - 121 . doi: 10.1016/j.conctc. 2016.05.003 http://dx.doi.org/10.1016/j.conctc.2016.05.003 .
MA P , LIU X , LIU Z , et al . The SHARE: SHam acupuncture REporting guidelines and a checklist in clinical trials [J]. J Evid Based Med , 2023 , 16 ( 4 ): 428 - 431 .
LEE YS , KIM SY , LEE H , et al . ACURATE: A guide for reporting sham controls in trials using acupuncture [J]. J Evid Based Med , 2023 , 16 ( 1 ): 82 - 90 .
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