Item 5: Description of participating acupuncturists (qualification or professional affiliation, years in acupuncture practice, other relevant experience)

Explanation:
Characteristics of the acupuncturists providing treatment should be reported, including qualification or affiliation, years in acupuncture practice, as well as any other experience that may be relevant to the trial. Relevant differences (if any) in the qualification, training and experience of the participating acupuncturists should be highlighted. The recent survey of authors of acupuncture trials and reviews reinforced the need for these characteristics to be reported well (1) , especially since the actual level of reporting has historically been poor. (2)   In trials where different acupuncturists provide treatment to different treatment arms, the background of both groups should be reported. The eligibility criteria for acupuncturists should be explained, as these will influence generalisability of the trial results. Where there are known to be potential variations between practitioners, selecting a random sample of practitioners will reduce expertise bias and help improve the applicability of the results. (3)

Examples:
i) Physicians had a median of 350 hours (range 140–2508 hours) of acupuncture training before participating in the trial; 33 (73%) had the B-Diploma. Seventeen (17; 38%) trial physicians taught acupuncture in accredited postgraduate courses. The physicians had used acupuncture in their practices for an average of 11 years (median 10, range 0–25) and had treated 346 patients (range 22–1200) with acupuncture in the year before the trial. Forty-one physicians (92%) indicated that they frequently or always make a Chinese syndrome diagnosis before starting treatment. (4)
ii) Eight US-trained and licensed acupuncturists with a median of 10 years of experience (range 4-18 years) provided study treatments in their private offices. One investigator trained the acupuncturists in the study procedures to increase their comfort with delivering all 4 treatments and monitored compliance with the protocol throughout the study. (5)
iii) Of the 11 midwives participating in the study, six had been taught acupuncture for midwives at the Norwegian School of Acupuncture/NFKA.  These six gave real and false acupuncture, whereas the others, who had been trained in acupuncture by the six, were allowed only to give false acupuncture. (6) 

   (1) Prady SL, MacPherson H. Assessing the utility of the standards for reporting trials of acupuncture (STRICTA): a survey of authors. J Altern Complement Med 2007 Nov;13(9):939-43.

   (2) Prady SL, Richmond SJ, Morton VM, MacPherson H. A Systematic Evaluation of the Impact of STRICTA and CONSORT Recommendations on Quality of Reporting for Acupuncture Trials. PLoS ONE 2008;3(2):e1577.

   (3) Devereaux PJ, Bhandari M, Clarke M, Montori VM, Cook DJ, Yusuf S, et al. Need for expertise based randomised controlled trials. BMJ 2005 Jan 8;330(7482):88.

   (4) Brinkhaus B, Witt CM, Jena S, Linde K, Streng A, Irnich D, et al. Interventions and Physician Characteristics in a Randomized Multicenter Trial of Acupuncture in Patients with Low-Back Pain. The Journal of Alternative and Complementary Medicine 2006 Sep 1;12(7):649-57.

   (5) Assefi NP, Sherman KJ, Jacobsen C, Goldberg J, Smith WR, Buchwald D. A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia. Ann Intern Med 2005 Jul 5;143(1):10-9.