Additionally, all patients completed a questionnaire on their general, health related quality of life (short form, SF-36)14 and adverse effects. The physicians documented medical history, diagnoses and adverse effects. We evaluated overall cost effectiveness from a social perspective (cost data were provided by the social health insurance funds). The quality adjusted life years (QALYs) were calculated from the SF-36 data.15 The incremental cost effectiveness relationship (cost per QALY gained) was expressed in Euros per QALY and resulted from the difference of the mean costs (direct and indirect, of both acupuncture and control groups), divided by the difference between the mean QALYs of both groups three months after the study began. Acupuncture Safety and Health economics studies (ASH) The aim of this prospective observational study was primarily to investigate safety on a large number of patients.11 The safety evaluation consisted of two stages. In the first stage, all patients completed a standardised questionnaire on adverse effects at the end of the acupuncture treatment. In cases where adverse effects occurred, those patients progressed to a second stage and completed a detailed, standardised questionnaire. Results A total of 304 674 patients treated by over 10 000 physicians in the period from December 2000 to March 2005 were included in the studies and analysed (ART: 1164; ARC: 43 351; ASH: 260,159). This total comprised of 34.5% men (average age 53.1 ± SD 13.8) and 65.5% women (49.5 ± 14.2 years). The acupuncture patients received on average 10 ± 3 acupuncture treatments within three months. Efficacy – ART In the Acupuncture Randomised Trials the acupuncture groups of all four diagnoses demonstrated significant superiority (P Acknowledgments The Acupuncture Evidence Project: A Comparative Literature Review was funded by the Australian Acupuncture and Chinese Medicine Association Ltd (AACMA). Research and analysis was undertaken by John McDonald PhD. The Project was initiated and managed by Stephen Janz. Tables 3, 4, 5, and 6, and Sections 2 and 3 were written by John McDonald. Stephen Janz wrote the preface and the authors collaborated on Section 1, Tables 7 and 8, and the Appendix. Research design by Stephen Janz and John McDonald. The authors thank Professor Caroline Smith, National Institute of Complementary Medicine, Western Sydney University, for providing advice regarding evidence levels for assisted reproduction trials; Associate Professor Zhen Zheng, RMIT University, for identifying the evidence levels for post-operative nausea and vomiting and post-operative pain; Judy James for technical and editorial assistance; and the AACMA board for funding and supporting this project. The authors also thank Dr Suzanne Cochrane, Western Sydney University; Associate Professor Chris Zaslawski, University of Technology Sydney; and Associate Professor Zhen Zheng, RMIT University, for providing pre-publication commentary and advice. Conflicts of interest Dr John McDonald was a co-author of three of the research papers referenced in this review. Professor Caroline Smith was a co-author of six of the research papers referenced in this review, and Associate Professor Zhen Zheng was co-author of one of the research papers in this review. There were no other conflicts of interest. The Acupuncture Evidence Project is a publication of the Australian Acupuncture and Chinese Medicine Association Ltd. © Australian Acupuncture and Chinese Medicine Association Ltd 2016, 2017. First published December 2016. Revised and updated 17 January 2017. This document should be cited as: McDonald J, Janz S. The Acupuncture Evidence Project: A Comparative Literature Review (Revised edition). Brisbane: Australian Acupuncture and Chinese Medicine Association Ltd; 2017. http://www.acupuncture.org.au. Electronic documents This work is copyright. You may download, display, print and reproduce this material in unaltered form only (retaining this notice) for your personal, non-commercial use, or use within your organisation. Apart from any use as permitted under the Copyright Act 1968, all other rights are reserved. ISBN 978-0-9954289-3-5 Requests for further authorisation should be directed to: The Australian Acupuncture & Chinese Medicine Association Ltd. PO Box 1635 COORPAROO DC QLD 4151 or via http://www.acupuncture.org.au. Paper-based publication This work is copyright. Apart from any use permitted under the Copyright Act 1968, no part may be reproduced by any process without written permission from the Australian Acupuncture and Chinese Medicine Association Ltd. ISBN 978-0-9954289-2-8 Requests and inquiries concerning reproduction and rights should be addressed to: Australian Acupuncture and Chinese Medicine Association Ltd. PO Box 1635 COORPAROO DC QLD 4151 or via http://www.acupuncture.org.au. Disclaimer This document aims to review the best available evidence to assist in decision-making. The authors and the Australian Acupuncture and Chinese Medicine Association Ltd give no warranty that the information contained in this document and any online updates available on the AACMA website is correct or complete. Neither the authors nor the AACMA shall be liable for any loss whatsoever whether due to negligence or