Expectancy Effect of Acupuncture on Cancer-Related Outcomes: A Systematic Review.
Hannah Choi, Shuang Gao, Judith M Schlaeger and 5 others
PMID 39431691WHAT IT FOUND
In cancer survivors receiving acupuncture, higher baseline expectancy was linked with symptom improvement in three studies, not in two; some other studies only reported expectancy.
Expectancy may shape response but does not prove acupuncture works.
Key findings
01Five studies tested whether expectancy was related to outcomes; three found positive associations, and two found none.
02Expectancy was linked with insomnia, pain, or bowel frequency in some studies, but not with emesis or chemotherapy-induced neuropathic pain.
03Four studies used the Acupuncture Expectancy Scale, and six used researcher-made questionnaires without reported reliability or validity testing.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only ten studies were included, and they used different designs, acupuncture methods, controls, outcomes, and expectancy measures. Five studies examined expectancy-outcome associations, and four reported expectancy without testing associations, so the evidence base for the main question was small and uneven. Many included studies had some concerns, serious, or high risk of bias; only two showed low risk of bias. The review searched only English-language articles, and no English-language studies from Asian countries were found; studies from Chinese databases were excluded if they did not measure expectancy. Expectancy measures were not standardised; six studies used researcher-made questionnaires without reported reliability or validity testing. The review did not combine study results statistically, so it cannot give an overall estimate of how much expectancy matters.
Declared interests
The authors declare no competing financial interests. The publication types list NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not read this as evidence that acupuncture works or that improving patient expectancy will improve outcomes. The review found mixed associations, many included studies did not test expectancy against outcomes, and the studies were too heterogeneous to combine.