Table 2 Thematic information on factors affecting the quality of acupuncture clinical trials

Trial design

Design of the trial

Building the research team

12

23

Formation the research question

8

39

Designing proposal in a standard

5

7

Writing the proposal

32

228

Standardizing acupuncture terminology

1

6

Conducting pilot trial

Familiar with the process

2

2

Refining the pilot trial

3

3

Ethics approval

The factors of  researcher

4

5

The factors of ethics committee

7

11

The factors of the duration of the trial

1

1

The factors of the funding

3

3

Registration

The factors of the researcher

12

35

Some journals do not uniformly require the registeration

1

1

The existence of "post-registration"

2

2

Trial conduction

Characteristics of acupuncture

Cost of time-distance for acupuncture

3

4

Needling sensation response

5

5

Differences in acupuncture manipulation

1

1

Specificity of acupoints

2

2

Research platform and environment

Availability of funding

1

1

Research platform

2

2

The factors of the acupuncture treatment environment

2

2

Coordinated management of the research team

Training & assessment  of SOP of the acupuncture trial

10

21

Selection of researchers

2

2

Researcher's responsibilities

2

3

The qualification of the research team

3

3

Subjective initiative of the researchers

1

1

The timetable of trial

4

4

Management of risk of bias

1

1

The factors of the acupuncture practitioners

Differences in acupuncture practitioners

16

31

Conduction  of the trial

16

38

Communication between acupuncture practitioners and patients

7

10

The blinding factors for acupuncture practitioners

7

9

The standardization of the acupunctureprocedure

7

11

The factors of outcome evaluator

Truthfulness of data

25

66

The degree of standardization of data management

5

7

SOP for outcome evaluation

2

2

The qualification of the outcome evaluator

18

25

The blinding  factors of outcome evaluator 

7

9

Third-party assessment

3

4

The factors of statistician

Whether the investigator followed the research proposal

1

1

Whether the data statistics were standardized

10

14

Check the integrity of the data

1

1

Blinded statistican

3

3

The factors of monitoring    

The factor of funding

1

1

The monitoring was conducted according to SOP

3

3

The method of monitoring

10

15

Researcher participant in monitoring

1

1

Monitoring during trial conduction

11

16

The factors of trial assistants

Assessment of the treatment compliance in patients

3

4

The researcher's scientific research capacity and research motivation

2

3

Conduction of random methods and allocation of concealment

4

5

Grouping of  patients

7

9

Conduction within of ethical principles

1

1

The factors of patients

Informed consent of petients

3

6

The influence of patients on the authenticity of data

16

22

Expectations effects in patients

10

11

Patients' preference

7

9

Patients' variability

4

4

Patients' compliance

29

155

The educational levels of  patients

3

4

Patients' cultural context

1

1

Get support from family and friends

4

5

The blinding factors of patients

8

12

The study was ahead of time or delayed

11

16

Research results reporting and publication

The factors of authors

The capacity of scientific research

8

10

Reporting focused only on the outcome rather than the process

1

1

Selective reporting of the results

1

1

Not reporting in accordance with reporting guideline

5

9

Incomplete reporting of results 

19

60

The factors of journals or editors

Quality control of acupuncture clinical trials by journals

5

5

Publication bias

3

3

Long time of peer review

3

3

Journals could provide guideline for reporting trial design

4

4

The reporting of the trial was limited by the journals' page number

4

5

Different journals have different reporting requirements

2

2

Research evidence dissemination

The factors of acupuncture  characteristics

The development of acupuncture

1

1

The characteristics of acupuncture therapy

2

2

The mechanism of acupuncture was not clear

1

2

Difficulties with acupuncture manipulation

1

2

The factors of health policy makers

Resources related to acupuncture were not properly allocated

1

1

The factors of the research team

Low quality of acupuncture trial 

1

1

Lack of awareness of dissemination  of research team

2

2

The research team do not have sufficient awareness about their aim of acupuncture trial 

1

1

Can't publish high-quality trial in international journal 

1

1

The factors of people who use evidence  

Clinicians don't understand acupuncture

1

1

Clinicians do not adopt research  results

4

5

Acupuncturists in the community do not care about the high-quality acupuncture papers

1

1

The factors of public

The public don't understand acupuncture

1

1

Public expectations of acupuncture efficacy

1

1

The level of trustful of acupuncture

1

1

Heterogeneity of patients

1

1

Research evidence transformation and application

The factors of transformation platform

Some hospitals lack the conditions for transformation the clinical trial

2

2

Different environment of research and clinical practice 

1

1

The factors that characterize acupuncture

Differences in genres of acupuncture

2

2

Characteristics of the discipline of acupuncture

6

11

The factors of the proposal

The low qualification of the research team

3

6

Lack of innovation

1

3

Lack of standardization

2

3

Low transparency of the whole trial

2

4

Lack of awareness of advocacy and dissemination among of the research team

5

14

The factors of research team 

Lack of teams that could transform and apply the evidence

2

2

Lack of awareness of transformation and application

1

1

Differences in acupuncture practitioner

4

7

Some acupuncturists don't understand the proposal

1

1

Transformation and application not strictly following the proposal

3

3

The factors of patients

Selection and characteristics of patients

2

2