Sandro Graca

Background:Case reports and clinical registry data are underused sources of real-world evidence in acupuncture and herbal medicine (AHM). This study explored researchers' reflections on conducting secondary analyses of acupuncture case reports and clinical registry data relating to pain.Methods:An anonymous qualitative survey was conducted with members of an international pragmatic research team (n=8) engaged in secondary analyses of AHM case reports and clinical registry data. Eight open-ended questions explored respondents’ experiences of collaboration, data complexity, evidence synthesis, and professional learning. Survey responses were analysed using descriptive thematic analysis, following established phases. Perplexity Pro was used in a limited, supportive role to assist with initial topic clustering and clarity checks, exploring the use of artificial intelligence (AI)-powered tools in qualitative data analysis. All coding, interpretation, and theme development were researcher-led.Results:Five interrelated themes were identified: (1) ambitious and integrative aims; (2) working with messy, real-world data under time pressure; (3) the value and strain of international, multidisciplinary collaboration; (4) re-thinking evidence synthesis and the role of case reports; and (5) learning, growth, and future priorities for AHM. Respondents described the challenges of heterogeneous clinical data and the benefits of collaborative mixed-methods inquiry.Conclusion:This study highlights how reflective collaboration and iterative learning can support the collective analysis of complex, real-world data. Secondary analysis of case reports and clinical registry data, conducted through international and multidisciplinary collaboration, has the potential to contribute to evidence development in AHM. Continued attention to collaborative research frameworks, transparent reporting practices, and practitioner education will be important for strengthening the quality and impact of future practice-based AHM research.

Artificial intelligence (AI)-powered large language models, such as ChatGPT, are increasingly used by the public for health information. The reliability of such novel AI-tools in providing credible polycystic ovary syndrome (PCOS) information/advice requires investigation. Healthcare professionals involved in PCOS care ( n = 43 from 14 countries) used a 5-point Likert scale to evaluate ChatGPT-generated responses to frequently asked questions about PCOS against the corresponding patient-orientated, evidence-based recommendations/responses available online. ChatGPT responses were rated significantly higher than the evidence-based responses for 11 of the 12 study questions, with moderate to large effect sizes ( r _{r b} = −0.46 to −1.00; all p -values p < 0.05). Readability analyses found no statistically significant differences between ChatGPT and evidence-based responses. However, using ChatGPT for simplifying the responses resulted in significant improvement. ChatGPT holds potential as a complementary patient self-education tool in PCOS, capable of interactive engagement and simplifying medical language. Further research is needed to identity optimal integration of AI tools and validate their clinical applicability for PCOS self-education/management.

Introduction: Clinical trials of acupuncture are difficult to meaningfully aggregate due to small sample sizes, and reductionist, heterogenous outcome measures. To improve the quality of evidence, standardized reporting of minimum data that reflects whole-person health, essential to East Asian Medicine (EAM), is needed. The Core Outcome Measures in Effectiveness Trials (COMET) initiative (1) offers a methodology for developing core outcome sets (COS) through collaborative group consensus, including consumers. This study presents the ‘Acupuncture Sets of Trial Reported Outcomes’ (ASTRO) for women’s health. Using domains of pain, sleep, mood/cognition, and safety, the ASTRO framework captures EAM complexity as well as standardizing reporting outcomes. Purpose: To develop a COS for acupuncture trials in women’s health, reflecting whole-person health outcomes across the lifespan. Methods: Following COMET guidelines, we used a three-stage consensus process involving practitioners, researchers, patients, and policymakers to develop a COS for reporting minimum data for acupuncture trials in women’s health. This process involved a systematic review, roundtable discussion, two-round Delphi survey, and a consensus meeting. We examined the conditions of menstrual health, PCOS, fertility, pregnancy, and menopause to develop an outcome set for safety, feasibility and EAM specific outcomes. Results: From 320 studies, 579 outcomes were identified. A final COS of 12 outcomes was agreed upon: Safety (n=2): Serious adverse events (SAEs) and minor adverse events (AEs); EAM (n=8): Changes to primary and secondary patient reported outcome measures (PROMs), change in EAM diagnostic indices, patient experience/satisfaction, demographics, mood/cognition, sleep, and pain; Feasibility (n=2): Acceptability and cost. Definitions for S/AEs follow Witt et al. (2) and Bäumler et al. (3), and outcomes are to be used in conjunction with those specified in the STRICTA guidelines (4). Conclusion: The ASTRO Women’s Health COS enables consistent, whole-person outcome reporting, to improve the quality and comparability of acupuncture research. Summary box: Definitions of terms:

The current landscape of acupuncture education is marked by significant challenges including the closure of prominent schools and a decline in student enrollment. Addressing these issues requires innovative approaches that improve educational content and student engagement. Given the recognized interest in research amongst students, integration of research skills into acupuncture education is vital in the development of students into practitioners who are equipped with critical thinking. These skills enable meaningful engagement with scientific literature and facilitate the delivery of evidence-based care. Production of a case report goes beyond taking simple case histories and provides a practical bridge between theory and clinical practice by teaching students research skills (systematic data collection, detailed analysis, and critical evaluation of treatment outcomes). The work involved in case reports enhances diagnostic skills, clinical reasoning, and communication with peers and other healthcare professionals. When used in conjunction with pragmatic data sets, case reports may be used in secondary analyses that reflect real-world clinical settings in a more practical way than clinical trials providing insights into broader clinical patterns and outcomes. The integration of research-focused learning prepares students for evidence-based practice, promotes interdisciplinary communication, and supports professionalism in acupuncture through contributions to the clinical evidence base.