Acupuncture versus cognitive behavioral therapy for anxiety among cancer survivors with insomnia: An exploratory analysis of a randomized clinical trial
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Bibliographic record
Abstract
Background Anxiety and insomnia frequently co-occur among cancer survivors and are strongly interconnected, yet no widely accepted intervention simultaneously targets both symptoms. Methods Data were drawn from a dual-center, parallel-group, randomized, comparative effectiveness trial evaluating acupuncture versus CBT-I for insomnia. Seventy-six participants with baseline Hospital Anxiety and Depression Scale-Anxiety (HADS-A) scores of ≥8 were included. Both interventions were administered over eight weeks, with follow-up until 20 weeks. Anxiety was assessed at baseline, week 8, and week 20 using HADS-A. A linear mixed-effects model was used to examine mean change in HADS-A scores. Additionally, responder analyses were conducted, with insomnia and anxiety responders defined as patients demonstrating clinically meaningful improvements in either outcome by week 8. Results: Both CBT-I and acupuncture significantly reduced HADS-A scores at week 8 (CBT-I -3.75; acupuncture: -3.14) and week 20 (CBT-I: -3.05; acupuncture: -2.66) compared to baseline (all p < 0.001). There was no between-group difference (p=0.85). In responder analyses, CBT-I showed greater anxiety reduction in insomnia responders (-4.62) than non-responders (-0.45), at both time points (week 8: p =0.0046; week 20: p =0.038). In the acupuncture group, the difference in anxiety reduction between insomnia responders (-3.96) and non-responders (-1.58) was not statistically significant. Conclusion Both acupuncture and CBT-I effectively manage comorbid anxiety and insomnia in cancer survivors. Acupuncture may address these symptoms independently, while CBT-I may improve them in an interconnected manner. Trial registration ClinicalTrials.gov registration (NCT02356575)
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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 | 0.009 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.000 | 0.003 |
| 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