Education and training of acupuncture providers affect the results of systematic reviews and meta-analyses

Despite widely used in today's clinical practice, recent systematic reviews and meta-analyses most often report that trials of acupuncture efficacy are equivocal or contradictory. Besides the low quality of trials and publication bias, the differences in education and training of acupuncture providers between East Asia and North America and Europe are often ignored, which may play a role in the results of randomized controlled trials; this can lead to further problems with subsequent systematic reviews and meta-analyses. Since acupuncture originated in China and is widespread throughout Asia, the exchange and cooperation of methodology and qualified professional acupuncture programs between Asia and North America and Europe might be directions for future research on acupuncture. A relative standard education and training of acupuncture should be established.