To prevent the exploitation of those desperate to find a cure for their chronic and often incurable disease, it is important that alternative and complementary therapies undergo the same scientific scrutiny and regulation as traditional allopathic medical therapies. The randomized controlled trial (RCT) has become the “gold standard” in medicine by which to judge the effect of an intervention on patient outcome, because it provides the greatest justification for conclusion of causality, is subject to the least bias, and provides the most valid data on which to base all measures of the benefits and risk of particular therapies. For alternative therapies to become accepted by the medical community and become integrated into a patients’ treatment plan, it is essential that they be tested in an RCT. As most forms of alternative therapy require an individualized approach, an RCT can best be performed using a sham treatment arm, with both the patient and investigator being blinded to the treatment received. Using this approach, chiropractic manipulation has been shown to be as effective as sham chiropractic manipulation for the treatment of childhood asthma,4while the benefit of homeopathy has been demonstrated for the treatment of asthma as well as allergic rhinitis and vertigo.5–7 In this issue of CHEST, Shapira and coworkers (see page 1396) conducted a randomized, double-blind, sham-controlled, crossover study of short-term acupuncture in patients with moderate persistent asthma. Each patient received four sessions of individualized acupuncture or sham acupuncture. In this carefully controlled and executed RCT, personalized short-term acupuncture therapy showed no benefit. Peak flow, bronchial reactivity as determined by methacholine challenge, asthma symptoms, and mediation usage were unaffected by acupuncture. The study population was well characterized and represented a homogeneous group of patients.