Traditional Chinese Acupuncture was not superior to sham acupuncture for knee osteoarthritis but delivering treatment with high expectations of improvement was superior to delivering treatment with neutral expectations
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
QUESTION: What are the comparative effects of Traditional Chinese Acupuncture (TCA) and sham acupuncture for patients with knee osteoarthritis (OA) when controlling for the effect of the acupuncturists' communication styles. DESIGN: A nested 2-stage randomised clinical trial, where patients were randomised to 1 of 3 style groups, waiting list, high expectations, or neutral expectations, and nested within style, TCA, or sham acupuncture. SETTING: A hospital general internal medicine department in Texas, USA. PARTICIPANTS: Men and women over 49 years with knee OA according to the American College of Rheumatology criteria. Additional inclusion criteria were pain in the knee in the preceding 2 weeks, > 3/10 on a visual analogue scale, no prior treatment with acupuncture, stable treatment with nonsteroidal anti-inflammatory drugs, analgesics, or glucosamine. Exclusion criterion was intraarticular injections in the knee in the previous 2 months. Randomisation of 560 participants allocated 238 to the high expectations group, 242 to the neutral expectations group, and 80 to the waiting list group. INTERVENTIONS: Six acupuncturists licensed in traditional Chinese medicine carried out the intervention. For the communication style intervention, providers conveyed high expectations of improvement, by using positive utterances such as 'I think this will work for you', while neutral expectations were conveyed with uncertainty utterances such as 'It may or may not work for you'. For the acupuncture intervention the procedure and specific points were standardised by a panel consisting of the acupuncturists in each of the 2 arms: TCA points on the basis of clinical practice, and sham points outside the relevant meridians. OUTCOME MEASURES: The primary outcomes were Joint-Specific Multidimensional Assessment of Pain (J-MAP), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale, and Satisfaction with Knee Procedure (SKIP) measured at 4 weeks, 6 weeks (end of treatment), and 3 months. RESULTS: 527 (94%) participants completed the study. There were no significant differences between the TCA and sham groups in any of the outcome measures. Patients in the high expectations communication style group had statistically significant improvements in pain (J-MAP) and satisfaction (SKIP) compared with the neutral group. Mean differences (95% CI) at 3 months follow up were 0.4 (0.1 to 0.7) for J-MAP (1 to 7 scale), and 0.2 (0.03 to 0.3) for SKIP (1 to 5 scale). CONCLUSION: In patients with knee OA, needling of meridian points was not more effective than the use of sham points, whereas acupuncturists' communication styles had a small but statistically significant effect on pain reduction and satisfaction.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it