Table 2 All included studies

TRADITIONAL ACUPUNCTURE

Dong H, Ludicke F et al (2001)

Vasomotor

'Classic manual acupuncture (based on the principles of TCM)'

11

Diagnosis and treatment was given based on the interpretation of symptoms and signs of based on TCM; treatment was individualised.

Huang MI, Nir Y et al (2006)

Vasomotor

Based on 'the principles of TCM'

29

Points were selected from a group that were selected according to TCM patterns but the authors mention elsewhere 'based on their ability to target hot flashes'. There was a degree of interpretation, and an individualised approach on the part of the practitioner.

MEDICAL ACUPUNCTURE

Wyon Y, Lindgren R et al (1995)

Vasomotor

'classical acupuncture'

24

No rationale given as to why choosing points for a different syndrome/disease (dysmenorrhoea) except that they didn't know what else to do. As the rationale for treatment is based on matching the mechanism of disease with the mechanism of acupuncture - this group have rationalised that beta-endorphins are the key link.

Hammer M, Frisk J et al (1999)

Vasomotor

-

9

These were male participants given a fixed-point prescription chosen for dysmenorrhoea because the mechanism of vasomotor symptoms is hypothesised to be linked to the production of beta-endorphins.

Cohen SM, Rousseau ME, Carey BL (2003)

Vasomotor

'Within Eastern thought, acupuncture is viewed as a holistic approach grounded in Chinese medical philosophy.'

18

Much TCM language is used in the paper but the points were the same fixed prescription as the other MA vasomotor papers, the rationale for treatment is based on matching the mechanism of disease with the mechanism of acupuncture - this group have rationalised that beta-endorphins are the key link.

Wyon Y, Wigma K et al (2004)

Vasomotor

-

45

As the rationale for treatment is based on matching the mechanism of disease with the mechanism of acupuncture - this group have rationalised that beta-endorphins are the key link and have used the same fixed-point prescription as the other vasomotor studies.

Nedstrand E, Wikma K et al (2005)

Vasomotor

-

38

As the rationale for treatment is based on matching the mechanism of disease with the mechanism of acupuncture - this group have rationalised that beta-endorphins are the key link and have used the same fixed-point prescription as the other vasomotor studies.

UNCLASSIFIABLE

Deng G, Vickers AJ, et al. (2007)

Vasomotor

-

72

The fixed point 'prescription was derived from previous reports and from expert opinion, as found in standard acupuncture textbooks.' It was also changed mid-way through when a change of acupuncturists who wanted to use different points meant the study had to be started again. The is no explanation offered as to why these points might have a certain effect.

Frisk J, Carlhall S et al (2008)

Vasomotor

-

45

Insufficient detail is provided on the acupuncture intervention. Reference is only made to the Wyon Y, Lindgren R et al (1995) study. No other rationale or detail about the treatment is provided.

Harris RE, Tian XM et al (2005)

Fatigue

'The active point formula was chosen based on the points' ability to relieve fibromyalgia symptoms in TCM.'

114

Although the authors describe the study being based on TCM with the knowledge of two acupuncturists, a fixed-point prescription was used according to its effect on symptoms. It is difficult to make further judgement as no rationale was offered as to why these points were chosen or how they might be expected to work.

Kho HG, Eijk RJR et al (1991)

Fatigue

-

29

A fixed-point prescription was used. No information was given regarding rationale for treatment, or mechanism of acupuncture and how it might work in this circumstance.

Malassiotis A, Sylt P, Diggins H. 2006

Fatigue

Point selection was '...based on the Traditional Chinese medicine style, although individualisation was not part of the study.'

47

The points selected are chosen because they have been 'traditionally used for 'energy' over the past 2000 years'. The authors hypothesised why the acupuncture may have worked but this did not drive the fixed-point prescription, which was selected after consultation with two acupuncturists with no rationale offered other than the above or references given.

Martin DP, Sletten CD et al (2006)

Fatigue

-

60

The authors chosen points that 'commonly recur in the acupuncture literature'. No rationale was offered as to why these points might have an effect. A fixed-point prescription was used.

Vickers AJ, Strauss DJ et al (2004)

Fatigue

'Traditional Chinese acupuncture'

37

The authors chose a selection of points that they say are traditionally used to treat fatigue referring to a textbook. There is no index by symptom in this (point-location) textbook thus all points have to be looked up individually and made use of according to TCM theory. A fixed-point prescription is used but is changed during the study with no explanation.