8 grouped with related sub-questions that ask whether study participants, practitioners, and assessors were reported as blinded (question no. 16). While this grouping is appropriate as a single CONSORT guideline, a greater impact on overall scoring might be achieved if this sub-item was a separate question. One can also argue that the comprehensiveness of OCSI is unnecessary to identify ﬂaws in reporting and we should seek instead to identify a core set of questions that produce a quality score suﬃciently similar to the total OCSI score. A potentially fruitful approach would be to survey stakeholders in the quality of reporting arena for sake of creating a weighting system for questions. Such an approach would minimize the “fatal-ﬂaw” scenario of the unweighted instrument wherein a high score is achieved despite failure to report an item generally regarded as essential to “good reporting.” For this initial creation and application of OCSI, however, our goal was not to identify those items most essential for rigorous research design but to provide a means to assess comprehensive reporting in acupuncture RCTs, consistent with the aims of CONSORT and STRICTA. Finally, in regard to application of the present ﬁndings, it is important to stress that quality of reporting is only a ﬁrst step toward assessing the evidence base. For example, receiv- ing high scores for reporting interventions may be of ques- tionable clinical relevance if what is being reported are inad- equate or inappropriate treatments that, in turn, may have contributed to reduced eﬃcacy. Similarly, participant selec- tion criteria, outcome measures, or statistical procedures that are clearly reported may score high on OCSI despite being insuﬃcient or inappropriate matches to the research question, the condition studied, the intervention provided, or the analysis of results. Thus, while OCSI may be regarded as a comprehensive tool for assessing quality of reporting, additional instruments as well as expert practitioner and statistician panels are needed to assess adequacy of the inter- vention and clinical relevance of the overall research design [56–60]. To this end, our aim is to improve OCSI within the context of a more complete strategy for assessing and build- ing an evidence base for acupuncture. We also encourage the use of OCSI as a model for developing quality of reporting tools for other therapies that have already created oﬃcial and unoﬃcial CONSORT extensions similar to STRICTA, such as herbal interventions [61] and homeopathy [62]. Appendices A. Oregon CONSORT-STRICTA Instrument (OCSI) Manual A.1. General Instructions (i) When scoring each question consider the following. (a) If you were a reviewer of the paper, would you be satisﬁed with what is reported? (b) If you were attempting to reproduce the ﬁnd- ings, is there suﬃcient reporting of details to allow you to do so? Evidence-Based Complementary and Alternative Medicine (ii) When multiple components (e.g., (i), (ii), (iii)) or “and” statements are listed for a question, all aspects must be met to receive full credit. (iii) Except in regard to question no. 1, if the information is placed ANYWHERE in the document, the question can receive full credit. (iv) For questions 4–9, which refer to STRICTA, nos. 4– 8 pertain ONLY to the acupuncture aspects of the study, while no. 9 pertains to all types of control or comparison groups. (v) Practitioners are almost always NOT BLINDED in acupuncture research; hence no. 16(b) is usually scored “N/A” (see no. 16(b) for further details). A.2. Instructions per Question. No. 1. It must state in the abstract or title that participants were allocated to interventions in a randomized manner, that is, “random allocation,” “randomized,” or “randomly assigned.” No. 2(a). “Scientiﬁc background” pertains to (i) the previous research and (ii) the current understanding of the disease. No. 2(b). “Rationale” pertains to the justiﬁcation for the trial and/or the expected eﬀects/beneﬁts of the treatment. No. 3(a). The distinction between inclusion and exclusion criteria is unnecessary; for example, an exclusion criterion may be listed as a negative within the inclusion criteria. Stating the patient demographics and clinical characteristics after recruitment (e.g., post hoc demographics) does not qualify as eligibility criteria. No. 3(b). “Settings,” for example, private practice or out- patient clinic and “Locations,” for example, medical center or acupuncture college, can be implied from the author aﬃliation information. No. 4(a). “Style of acupuncture” can be implied from the author aﬃliation information; for example, authors were from the Beijing TCM hospital, so style is TCM. If the protocol utilized a single acupoint or only lists the names of the acupoint(s), the style still needs to be stated. No. 4(b). For example, the acupoints were chosen on the basis of text books, practitioner survey, or prior research. No. 4(c). “Justiﬁed,” for a YES score, requires citing journals, texts, practitioner survey, or an expert panel. No. 5(a). Unilateral or bilateral can be implied. No. 5(b). If the treatment protocol is individualized, then the authors must state the range of needles utilized (e.g., 8–14 needles). This may be implied from no. 5(a). No. 5(c). If the treatments were individualized, the depths must be given as a range. Depths can be expressed in Cun, mm, or anatomical depth (e.g., subcutaneous tissue or muscle). No. 5(d). “Response” refers to needle sensations such as, de qi (TCM), muscle twitch (trigger point), or muscle contraction (electroacupuncture).