After carefully reading and analyzing the article Effectiveness of Electroacupuncture for Diabetic Peripheral Neuropathy and Exploring the Feasibility of Infrared Thermography1 that this study presents a randomized controlled trial (RCT) protocol, which is a research method to evaluate the effectiveness of the intervention. This research also involves several centers and stratifications based on the severity of DPN, and seeks to produce more representative and generalizable data.

In addition, this study also has a drawback, namely it does not include a placebo group to compare the effect of electroacupuncture with the effect of placebo, which can affect the validity of the results and allow the placebo effect to affect the results. According to Rino, 2021 used a placebo during the study to help them understand the effects of new drugs or other treatments that may be caused by certain conditions.2 In addition, study participants were drawn from multiple hospitals in a single region, which limited the generalization of outcomes to a wider population or to different geographic locations and potential for bias in outcome assessment could still exist even if outcome assessors were trained and did not know group allocation, and the possibility of bias remained, especially if the assessors had certain expectations about the outcome of the intervention. According to Pannucci,3 bias can be avoided with Known confounders controlling with study design or during data analysis. Unknown confounders can only be controlled with randomization.

These shortcomings need to be considered for a more careful interpretation of the results. Future research planning should include the addition of placebo groups, strictly control external variables, increase participant diversity, and more objective assessment methods. This is accordance Agussalim4 which recommends authors develop a more standardized intervention protocol for use in future studies.

By implementing these measures, research can be improved to produce more valid, reliable, generalizable results, as well as make greater contribution to the understanding of the effectiveness of electroacupuncture in the treatment of diabetic peripheral neuropathy.

The authors report no conflicts of interest in this communication.

1. Luo N, Zeng Y-C, Fu B-T, Low JW, Fang J-Q. Investigating the effectiveness of electroacupuncture for diabetic peripheral neuropathy. J Pain Rese. 2024;17:2727–2739. doi:10.2147/JPR.S472648

2. Presetyo R, Getting to know placebo, and its role in medical medicine research. Availabe from: https://topcareer.id/read/2021/02/13/45135/mengenal-placebo-dan-perannya-dalam-penelitian-pengobatan-medis. Accessed september04, 2024.

3. Pannucci CJ, Wilkins EG, Identifying and avoiding bias in research, NIH public access, 2010. Availabe from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2917255/pdf/nihms-198809.pdf. Accessed september04, 2024.

4. Agussalim. The effect of oral care intervention in mucositis management among pediatric cancer patients: an updated systematic review. J Multi Health. 2024;17:4071–4072. doi:10.2147/JMDH.S488007