according to the applications envisaged. 9. Selected acupuncture points for basic training Participants at the WHO Consultation on Acupuncture at Cervia, Italy in 1996 drew up a list of Commonly Used Points suitable for inclusion in basic training courses. These were selected from the document A Proposed Standard International Acupuncture Nomenclature: Report of a WHO Scientific Group (WHO, Geneva, 1991). As may be seen from the table below, the selection includes 187 of the 361 classical points, and 14 of the 48 extra points. Thus, the basic training courses for the categories of personnel described lay emphasis on the use of only 201 of a total of 409 points. The guidelines on safety, which follow, mention certain points as being potentially dangerous and requiring special skill and experience in their use. Some of these are included in the selection of Commonly Used Points, and attention is drawn to this fact. Efficacy, effectiveness, safety and costs of acupuncture for chronic pain – results of a large research initiative Claudia M Witt, Benno Brinkhaus, Thomas Reinhold, Stefan N Willich Abstract Background The aim of the ‘Acupuncture Model Project of the Techniker Krankenkasse’ was to determine efficacy, effectiveness, safety and cost effectiveness of acupuncture treatment in standard medical care. Methods We evaluated a total of 304 674 patients (34.5% men, aged 53.1±13.8 and 65.5% women, aged 49.5±14.2) who were in the care of over 10 000 physicians and received on average 10±3 acupuncture treatments for chronic pain (osteoarthritis of the hip or knee, low back pain, neck pain, headache) during a period of three months. Results and conclusions Our findings demonstrate that for the diagnoses examined, acupuncture in addition to usual care was an effective and safe treatment. Whether the effects of acupuncture can be attributed primarily to specific or nonspecific mechanisms appeared to depend on the diagnosis, and should be investigated in further studies. Using acupuncture as an adjunctive treatment was more expensive than usual care alone, but was cost-effective according to internationally accepted threshold values. Keywords Acupuncture, safety, cost effectiveness, chronic pain, randomised controlled trial (RCT). ACUPUNCTURE IN MEDICINE 2006;24(Suppl):S33-39. 34 http://www.acupunctureinmedicine.org.uk/volindex.php Clinical trials (Dieter Melchart, Klaus Linde) and investigated whether acupuncture was more effective than a) penetrating sham (minimal) acupuncture, and b) no acupuncture (waiting list control).6;7 In four randomised, controlled, partially blinded studies we included patients with the following chronic diagnoses: low back pain, pain due to osteoarthritis of the knee, migraine and tension headaches. Treatment for the acupuncture group involved deep needling of specific points following the principles of traditional Chinese medicine; for the non-acupuncture group it involved superficial needling of non-acupuncture points (for each group a total of 12 treatments over a period of two months). The waiting list control patients did not receive any acupuncture treatment until two months (three months in headache study) after randomisation. Assessment occurred at baseline, 2, 6 and 12 months (baseline, 12 weeks and 6 months in the headache study). The primary outcome measures for the clinical efficacy were assessed using the following validated questionnaires or methods: Low back pain: average pain during the last seven days measured on a visual analogue scale.8 Osteoarthritis of the knee: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).9;10 Tension-type headache or migraine: number of headache days documented in a diary. Acupuncture in Routine Care Studies (ARC) Four pragmatic randomised controlled studies with additional cohort studies evaluated the effectiveness of acupuncture in addition to usual care compared to usual care alone.11 Patients visiting their physician because of chronic low back pain, headache, pain due to osteoarthritis of the knee or hip, neck pain, who fulfilled predefined diagnosis-specific criteria and agreed to randomisation, were randomised into an acupuncture or a control group. Patients who rejected randomisation were included in a third non-randomised group. The patients in the acupuncture and non-randomised groups received acupuncture immediately (on average 10 sessions), the patients in the control group did not receive acupuncture until after three months. All patients were allowed to receive usual medical care. The patients completed standardised questionnaires at baseline, 3 and 6 months. The primary outcome measures for the clinical efficacy (relative to each diagnosis) were assessed using the following validated questionnaires or methods: Low back pain: Hanover Functional Ability Questionnaire.12 Figure 1 The design of the model project acupuncture: ART = Acupuncture Randomised Trial; ARC = acupuncture in Routine Care Studies; ASH = Acupuncture Safety and Health Economic Studies. ACUPUNCTURE IN MEDICINE 2006;24(Suppl):S33-39. 5 Clinical trials Headache: days with headache in the last four weeks. Osteoathritis of the knee or the hip: WOMAC Index.9;10 Neck pain: Neck Pain and Disability Scale.