It is noteworthy that almost all reported clinical studies on the effects of acupuncture on cancer or cancer therapy –related symptoms focus on symptom management rather than the disease itself. Investigations into the effects of acupuncture on chemotherapy -induced nausea and vomiting, many of which were randomized and well-controlled, produced the most convincing findings. Although a considerable number of favorable clinical acupuncture studies have been reported, most were case studies, clinical observations, or nonrandomized and poorly controlled clinical trials. In many studies, methodologic flaws in clinical study design hampered rigorous scientific efforts to evaluate the effects of acupuncture. Although pain relief is the most clinically common use of acupuncture, only a few studies on cancer pain are well-controlled or have sample sizes large enough to support their findings.

Separate levels of evidence scores are assigned to qualifying human studies on the basis of statistical strength of the study design and scientific strength of the treatment outcomes (i.e., endpoints) measured. The resulting two scores are then combined to produce an overall score. For additional information about levels of evidence analysis, refer to Levels of Evidence for Human Studies of Cancer Complementary and Alternative Medicine.

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