In Acupuncture research, the demand for an rigorous “sham” procedure has been relentless, and difficult to satisfy. To have a sham needle that doesn’t penetrate the skin is hard to pull off, but that is what is required.
Finally there is a to subject surgery to the same standard. To show that the actual surgery works better than a sham surgery. The most high profile example of a surgery that was proven to be no better than sham was arthroscopy for meniscal repair. This was one of the most common surgeries performed in the U.S.