Hervik 2009.

Methods	Randomized, single‐blind study of women following a breast cancer surgery. 2 groups: TA and SA
Participants	59 postmenopausal women (no menstruation for at least 3 months) having finished treatment for breast cancer (chemotherapy or radiotherapy), treated with oestrogen antagonist, tamoxifen, for at least 3 months after chemotherapy or radiotherapy, and complaining of hot flushes (no severity limits) Women taking medication for hot flushes either prior to, or during the treatment and follow‐up period; having received previous acupuncture treatment; being treated with other complementary or alternative therapies simultaneously; having serious endocrine or vascular disorders; suffering from psychological problems; and having hypertension (diastolic blood pressure over 95 mm Hg) were excluded Setting: The Breast Centre at Vestfold Central Hospital in Norway
Interventions	TA: 30‐minute treatment were given for 10 consecutive weeks (twice per week the 5 first weeks and once per week the remaining 5 weeks) by a physiotherapist (the same for both TA and SA groups) having 3 years' certified training course and 15 years' practice. 8 needles (0.30 mm) were inserted 0.5‐3 cm deep at 8 points along meridians in TCM (LIV3, GB20, LU7, KI3, Sp6, REN4, P7 and LIV8, unilateral) and manually stimulated. The 'De qui' sensation was the elicited response SA: 30‐minute treatment were given for 10 consecutive weeks (twice per week the 5 first weeks and once per week the remaining 5 weeks) by a physiotherapist (the same for both TA and SA group) having 3 years' certified training course and 15 years' practice. 8 needles (identical to TA group) were inserted 2‐3 mm deep at 8 points well away from acupuncture and trigger points (bilateral)
Outcomes	Hot flushes frequency at day and night (data assessment tool not reported). Timing of assessment: each week for a period of 4 weeks prior to treatment, during the treatment (10 weeks) and for the 12 weeks following treatment Menopausal symptoms using the Kupperman index. Timing of assessment: at baseline, at the end of the treatment, and 12 weeks after treatment
Source of funding	The Norwegian Acupuncture Association (NAFO), University of Tromso (NAFKAM), and Vestfold Central Hospital
Notes	Follow‐up: 12 weeks (after completion of treatment). Additional data obtained from author by personal communication
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "Patients were randomized, using a sealed envelope technique, to receive either TA or SA" Comment: does not mention the randomization method
Allocation concealment (selection bias)	Unclear risk	Quote: "Patients were randomized, using a sealed envelope technique, to receive either TA or SA" Comments: not mentioned whether the envelopes were sequentially numbered and opaque
Blinding (performance bias and detection bias) All outcomes	Low risk	Quote: "Patients were blinded to the type of acupuncture received" "A neutral attitude towards the patients and potential treatment effects was attempted, and all data was handled by a secretary blinded to the treatment group"
Incomplete outcome data (attrition bias) All outcomes	Low risk	Quote: "All patients completed treatment"; "Number of hot flashes was recorded in all but one patient (SA group), the KI was obtained from all patients throughout the study period" No dropout Use of ITT approach or imputation method not mentioned Comments: unclear about what have been done with the missing data
Selective reporting (reporting bias)	Low risk	The published report included all expected outcomes
Other bias	Low risk	The study appeared free of other sources of bias