Objective:

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To summarize and identify the available instruments/methods assessing the adequacy of acupuncture in randomized controlled trials (RCTs) for proposing a new improved instrument.

Methods:

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A systematic literature search was carried out in 7 electronic databases from inception until 21st November 2022. Any study evaluating the adequacy or quality of acupuncture

specifying specific acupuncture treatment-related factors as criteria of subgroup analysis

or developing an instrument/tool to assess the adequacy or quality of acupuncture in an RCT was included. Basic information

characteristics and contents of acupuncture adequacy assessment were presented as frequencies and percentages.

Results:

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Forty studies were included in this systematic review. Thirty-five studies (87.50%) were systematic reviews

none of which used formal methods to develop the assessment instruments/methods of acupuncture adequacy; of 5 methodological studies

only 1 study used a relatively formal method. Thirty-two studies (82.05%) assessed the components of acupuncture

while 7 (17.95%) assessed the overall quality of acupuncture. An independent assessment instrument/method was used to assess acupuncture adequacy in 29 studies (74.35%)

whereas as one part of a methodological quality assessment scale in 10 (25.65%). Only 9 (23.00%) studies used the assessment results for subgroup analysis

sensitivity analysis or the criteria for inclusion in the meta-analysis.

Conclusion:

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Assessment contents for adequacy or quality of acupuncture in RCTs hadn't still reached consensus and no widely used assessment tools appeared. The methodology of available assessment instruments/scales is far from formal and rigorous. A new instrument/tool assessing adequacy of acupuncture should be developed using a formal method.