Table 3 Exploratory guide for assessing acupuncture model validity (for complex outcomes)

1. What is the underlying theory of healing and rationale?

• Derived or based within a TA model?

• Bio-medically based?

• Symptom based?

• Pattern differentiation (based on the approach of looking, listening, asking, touching)?

2. What form does the diagnosis of the patient take?

• Symptom based?

• Pattern differentiation (based on the approach of looking, listening, asking, touching)?

• Aetiology of the main complaint (detail and depth of exploration)?

3. What is the nature of the treatment process?

• Fixed set of acu-points selected according to the main symptom(s)?

• Is the treatment individualised?

• Treatment is characterised according to the diagnosis of the whole person using pattern differentiation?

4. How is treatment modified at subsequent treatment sessions?

• Treatment modified in response to patient-reported change?

• Treatment staying constant focussing only on the (main) symptom(s)?

5. What is the implied mechanism of change for how the acupuncture might work?

• Biomedical mechanism of the acu-points are linked directly to the symptom?

• Change is dependent on affecting the balance of Qi, Yin and Yang and other imbalances as defined by the differential diagnosis?

6. What outcomes are explored and what is the underlying rationale?

• Resolution of symptoms?

• Broader benefits on health and well-being?