The impact of patient expectations on outcomes in four randomized controlled trials of acupuncture in patients with chronic pain

@article{Linde2007TheIO,
  title={The impact of patient expectations on outcomes in four randomized controlled trials of acupuncture in patients with chronic pain},
  author={Klaus Linde and Claudia M. Witt and Andrea Streng and Wolfgang Weidenhammer and Stefan Wagenpfeil and Benno Brinkhaus and Stefan N. Willich and Dieter Melchart},
  journal={PAIN},
  year={2007},
  volume={128},
  pages={264-271}
}
Treatment Expectations and Preferences as Predictors of Outcome of Acupuncture for Chronic Back Pain
TLDR
Pretreatment expectations and preferences for acupuncture were not found predictive of treatment outcomes for patients with chronic back pain, and inconsistent results suggest that the relationship between expectations and outcomes may be more complex than previously believed.
The impact of placebo, psychopathology, and expectations on the response to acupuncture needling in patients with chronic low back pain.
Association of Pre- and Post-Treatment Expectations with Improvements after Acupuncture in Patients with Migraine
TLDR
A high level of expectation after acupuncture treatment rather than at baseline was associated with better long-term outcome improvements in patients with migraine.
The long-term effect of acupuncture for patients with chronic tension-type headache: study protocol for a randomized controlled trial
TLDR
Results from this trial will provide evidence for the long-term effect of acupuncture for CTTH with a long follow-up period, in comparison with superficial acupuncture.
The Effect of Patient Characteristics on Acupuncture Treatment Outcomes: An Individual Patient Data Meta-Analysis of 20,827 Chronic Pain Patients in Randomized Controlled Trials
TLDR
Only baseline pain severity was found to potentially moderate the treatment effect of acupuncture, with patients reporting more severe pain at baseline experiencing more benefit from acupuncture compared to either sham-control or non-acupuncture control.
No Effect of Acupuncture as Adjunctive Therapy for Patients with Total Knee Replacement: A Randomized Controlled Trial
TLDR
The results do not support the addition of acupuncture to routine rehabilitation, and previous benefit from acupuncture was not able to identify those likely to respond to acupuncture.
Integrating Acupuncture With Exercise-Based Physical Therapy for Knee Osteoarthritis: A Randomized Controlled Trial
  • Lan X. Chen, J. Mao, J. Farrar
  • Medicine
    Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases
  • 2013
TLDR
Pcturing acupuncture needles did not perform any better than nonpuncturing needles integrated with EPT, and expectation for relief was a predictor of reported benefit.
Patient confidence in acupuncture : returning for care and pain reduction
TLDR
This study failed to detect a significant difference between types or levels of confidence and returning for a 5 th visit; however a weak inverse association was observed between level ofconfidence and improvement in pain.
Identifying patients with chronic pain who respond to acupuncture: results from an individual patient data meta-analysis
TLDR
Evidence is not found to support the notion that there are exceptional acupuncture responders in patients with chronic pain, and the challenge remains to identify features of chronic pain patients that can be used to distinguish those that have a good response to acupuncture treatment.
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References

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Acupuncture in patients with chronic low back pain: a randomized controlled trial.
TLDR
Acupuncture was more effective in improving pain than no acupuncture treatment in patients with chronic low back pain, whereas there were no significant differences between acupuncture and minimal acupuncture.
Lessons from a Trial of Acupuncture and Massage for Low Back Pain: Patient Expectations and Treatment Effects
TLDR
The results of this study suggest that patient expectations may influence clinical outcome independently of the treatment itself, and general optimism about treatment, divorced from a specific treatment, is not strongly associated with outcome.
Acupuncture in patients with tension-type headache: randomised controlled trial
TLDR
The acupuncture intervention investigated in this trial was more effective than no treatment but not significantly moreeffective than minimal acupuncture for the treatment of tension-type headache.
Is Acupuncture Analgesia an Expectancy Effect?
TLDR
Although no statistically significant analgesic effect was observed between the acupuncture and placebo groups, participants in both experiments who believed they received real acupuncture reported significantly less pain than patients who believed that they received a placebo.
The Importance of Considering the Effects of Perceived Group Assignment in Placebo-Controlled Trials
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The report by Bausell et al. (2005 [this issue]) is not only a clinical trial showing that acupuncture is not better than placebo in reducing pain following dental surgery. Its importance goes beyond
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TLDR
The sham device had greater effects than the placebo pill on self reported pain and severity of symptoms over the entire course of treatment but not during the two week placebo run in, appearing to be malleable and depend on the behaviours embedded in medical rituals.
Effects of perceived treatment on quality of life and medical outcomes in a double-blind placebo surgery trial.
TLDR
The placebo effect was very strong in this study, demonstrating the value of placebo-controlled surgical trials, and there were numerous differences and changes over time.
Patient expectations in placebo-controlled randomized clinical trials.
TLDR
Expectations in RCTs are not fixed and instead may be viewed as continuously shaped by multiple inputs that include experience and information received both before and during the trial.
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