The most relevant reason why it is challenging to test the reliability of outcomes of acupuncture is:
It is difficult to design a double-blind study for this practice.
In acupuncture, the treatment involves inserting needles at specific points on the body, which complicates the double-blinding process commonly used in clinical trials to assess the efficacy of treatments. Participants may be able to discern whether they are receiving real acupuncture or a placebo (sham acupuncture), and practitioners may know which treatment they are providing. This can introduce bias and affect the reliability of the study's outcomes, making it challenging to determine the true effectiveness of acupuncture compared to a control group.