Background: There have been few previous reports of the reliability of acupuncture-point location and no previous reports of reliability at points that are near anatomical landmarks.

Objective: The objective of this research was to determine the internal agreement of 2 junior acupuncturists for marking surface acupuncture point locations (SAPLs) at 6 points bilaterally and to determine the agreement between an expert acupuncturist and each of the 2 junior acupuncturists at the same points.

Design: This research was designed to measure intrarater and between-rater agreement of SAPL marking on several volunteers.

Outcome measures: Total agreement probability (TAP) for intra-rater and between-rater markings.

Setting: This research took place at an academic rehabilitation center.

Subjects: The subjects were 22 healthy volunteers and the researchers were 3 physician–acupuncturists.

Interventions: For intrarater assessment, 2 junior acupuncturists marked 6 SAPLs bilaterally 4 times on 11 volunteers, using different colors of invisible ink. The points from each acupuncturist within a 0.5-cm radius circle placed to “best fit” were counted as agreements. For between-rater assessment, 2 junior acupuncturists marked the same SAPLs with invisible ink on 15 volunteers. An expert acupuncturist then placed an index mark at each SAPL. The marks that fell within a 0.5-cm radius of the index mark were counted as agreements.

Results: TAP within the observations of the 2 junior acupuncturists were 0.92 (confidence interval [CI] 0.89–0.94, p<0.05) and 0.96 (CI 0.94–0.97, p<0.05). TAP between the expert acupuncturist and the junior acupuncturists were 0.48 (CI 0.41-0.55, p=not significant [NS]) and 0.56 (CI 0.49-0.63, p=NS).

Conclusions: This study demonstrated that there was excellent intrarater agreement in surface marking at the selected acupuncture point locations. Agreement between the junior acupuncturists and the expert acupuncturist was much less robust. Further research is needed to determine if these findings are reproducible, what factors influence consistency of point location identification, and whether variance in acupuncture-point location affects treatment outcomes.