Background:Methodological issues and challenges hinder the high-quality development of acupuncture clinical studies.Objective:To systematically summarize the methodological issues,challenges,and recommendations in acu...Background:Methodological issues and challenges hinder the high-quality development of acupuncture clinical studies.Objective:To systematically summarize the methodological issues,challenges,and recommendations in acupuncture clinical research using the participant,intervention,comparison,outcome,and study design(PICOS)framework to generate a comprehensive list of methodological questions and recommendations.Methods:We searched seven databases for articles on the methodological aspects of clinical acupuncture research from their inception to March 24,2023.Two researchers independently screened the titles,ab-stracts,and full text of each article.Data extraction and analyses were performed for the eligible studies.Finally,the methodological challenges and recommendations for acupuncture clinical studies are listed,and the frequency of methodological challenges is displayed in a sunburst chart.Results:A total of 226 studies were included in the review,most of which originated in China(173,77%),followed by the United States(25,11%)and the United Kingdom(12,5%).Clinical research on acupuncture faces methodological challenges that span the five elements of the PICOS framework.The most frequently mentioned issues were related to comparison,followed by study design and interven-tions.If further categorized,the establishment of the control group is undoubtedly the most concerning issue for researchers.Conclusion:This review provides a comprehensive overview of the challenges and recommendations for each aspect of the PICOS framework in clinical acupuncture research.展开更多
Acupuncture is widely used for chronic pain with internationally recognized evidence [1].However,due to the large heterogeneity of acupuncture protocol,it is difficult to compare the effects related to factors such as...Acupuncture is widely used for chronic pain with internationally recognized evidence [1].However,due to the large heterogeneity of acupuncture protocol,it is difficult to compare the effects related to factors such as acupoints,stimulation parameters,or depths of needling for chronic pain.展开更多
Objective:To summarize the available evidence of acupuncture for pain relief in the patients with postherpetic neuralgia(PHN)using a scoping review.Methods:Seven electronic databases of the original studies of acupunc...Objective:To summarize the available evidence of acupuncture for pain relief in the patients with postherpetic neuralgia(PHN)using a scoping review.Methods:Seven electronic databases of the original studies of acupuncture on PHN were retrieved.The search time was from the inception to May 1,2021.Two researchers screened the title,abstract and full text of each article independently.The original studies that was met the inclusion criteria were collected and analyzed,and finally presented with a qualitative description.Results:A total of 216 original studies were eligible and all of them were randomized controlled trials.The acupuncture therapies with the highest use frequency included manual acupuncture,pricking and cupping and electroacupuncture.Acupuncture therapies were mostly combined with other interventions in studies.There were large differences in acupoint selection,time duration for single treatment and the total treatment times.It was believed in all of the included studies that acupuncture was effective of pain relief in PHN and 85.65%of the studies obtained the minimum clinical importance difference(MCID),suggesting the clinical effectiveness.The adverse reaction of acupuncture was low in its incidence,and mostly transient in occurrence.Conclusion:The study type of acupuncture for PHN is relatively simple.Most studies show the advantages of acupuncture in pain relief of PHN.The quality of study needs to be improved.展开更多
Adequate preliminary research is a prerequisite for ensuring the quality of randomized controlled trials(RCTs)on acupuncture.This paper proposes that prior to conducting a new RCT of acupuncture,an evidence-based rese...Adequate preliminary research is a prerequisite for ensuring the quality of randomized controlled trials(RCTs)on acupuncture.This paper proposes that prior to conducting a new RCT of acupuncture,an evidence-based research(EBR)approach and exploratory studies should be adopted to ensure value and avoid waste of research.EBR,defined as using systematic reviews of relevant clinical studies and obtain the perspectives of end users in a systematic and transparent way to justify research questions and inform trial design,is recommended as the first step before embarking on an acupuncture RCT to ensure its value and rationality.The subsequent exploratory studies can aid researchers in pre-evaluating the effect of acupuncture treatment protocols,identifying key factors that influence the outcome,and test trial feasibility for protocol optimization.This article elucidates the significance and implementation of the EBR approach and exploratory studies,with the aim of providing practical methods to enhance the quality of acupuncture RCTs。展开更多
Objective:The body of research on acupuncture as a treatment strategy for fibromyalgia(FM)is steadily growing.This evidence map identifies,describes,and summarizes the current status of studies conducted to evaluate t...Objective:The body of research on acupuncture as a treatment strategy for fibromyalgia(FM)is steadily growing.This evidence map identifies,describes,and summarizes the current status of studies conducted to evaluate the efficacy of acupuncture for FM,identify research gaps,and provide information that could guide the design of future studies.Methods:Seven electronic databases–Cochrane Library,PubMed,Embase,China Biomedical Literature Database,VIP,Wanfang Database,and Chinese National Knowledge Infrastructure–were searched for relevant articles on acupuncture for FM.The search period was from the dates of inception of the databases to December 19,2022.Original clinical studies and systematic reviews on the use of acupuncture-related modalities for the treatment of FM were included.The basic information,quality assessments,and evidence maps of the included studies are presented as charts and bubble plots.The quality assessment tools used for evaluating the different types of studies included in the present study were Cochrane Collaboration’s tool,Canadian Institute of Health Economics quality appraisal tool,and A MeaSurement Tool to Assess systematic Reviews 2.Results:Fifty studies were included in this study.Of these,39(78.00%)were randomized controlled trials(RCTs),6(12.0%)were case series,and 5(10.0%)were systematic reviews.The included studies focused on manual acupuncture and conventional treatment in the treatment and control groups,respectively.The outcomes analyzed in the RCTs included pain(94.9%),sleep quality(46.2%),depression(46.2%),physical function(46.2%),stiffness(35.9%),well-being(35.9%),work status(35.9%),anxiety(33.3%),fatigue(33.3%),quality of life(17.9%),and overall effective rate(10.3%).The methodological quality of most of the studies was low or critically low regardless of the study design.In most studies,the therapeutic effect of acupuncture was significantly superior to that of the comparator.展开更多
Background:Acupuncture is used to relieve symptoms,reducing recurrence,and improve the lives of patients with skin diseases.Objective:To identify,describe,and organize the available evidence on acupuncture for atopic ...Background:Acupuncture is used to relieve symptoms,reducing recurrence,and improve the lives of patients with skin diseases.Objective:To identify,describe,and organize the available evidence on acupuncture for atopic eczema(AE)using evidence mapping of randomized controlled trials(RCTs),systematic reviews(SRs),and metaanalyses.Methods:We searched eight databases from inception to October 30,2021,for RCTs,SRs,and metaanalyses of acupuncture for patients with AE.Two reviewers screened the papers,before extracting the data and assessing the quality of the included studies.The basic and clinical characteristics,and quality of assessment of the studies were assessed using descriptive statistics and qualitative analyses.A bubble plot was used to visualize the evidence map to indicate the relationship between the type and frequency of outcomes,the quality and overall effects of acupuncture,and the outcomes of the studies.Results:Forty-five studies(Forty RCTs,five SRs,and meta-analyses)were included.The number of publications increased rapidly after 2013 and peaked in 2019.The most frequently applied intervention was one type of acupuncture therapy.The most frequent comparison was between acupuncture and active medicine.The symptomatic outcome was the most commonly used,and the quality of the included studies was relatively low.All included studies showed a significantly better outcome in the acupuncture group compared to the control group(P<0.05).Most outcomes in the included studies were of low or critically low quality.Several symptomatic outcomes and health-related quality of life outcomes in the included RCTs indicated moderate quality,while some symptomatic outcomes and global symptom improvement in the included SRs and meta-analyses indicated low quality.Conclusion:The majority of studies related to acupuncture for AE indicated promising results,but with relatively low quality;thus,further studies with more robust designs should be conducted to validate the results.展开更多
Objective:To summarize and analyze the recommendations of acupuncture and moxibustion in the global guidelines/expert consensus of chemotherapy-and/or radiotherapy-induced nausea and/or vomiting,providing a basis for ...Objective:To summarize and analyze the recommendations of acupuncture and moxibustion in the global guidelines/expert consensus of chemotherapy-and/or radiotherapy-induced nausea and/or vomiting,providing a basis for the development of clinical practice guidelines on acupuncture and moxibustion for chemotherapy-and/or radiotherapy-induced nausea and/or vomiting.Methods:We systematically searched 7 comprehensive databases,7 guideline libraries and 4 websites of societies/associations.The retrieval period was from the inception to April 1,2023.Two researchers independently screened the literature,extracted data,and used the Scientific,Transparent,and Applicable Rankings(STAR)tool to evaluate the quality of guidelines/expert consensus that contained acupuncture and moxibustion recommendations,and analyzed acupuncture and moxibustion recommendations in guidelines/expert consensus and their evidence base.Results:A total of 56 guidelines/expert consensus related to the prevention and treatment of chemotherapy-and/or radiotherapy-induced nausea and/or vomiting were included,and 22 guidelines/expert consensus contained acupuncture and moxibustion recommendations,with a total of 34 recommendations on acupuncture and moxibustion(27 supports,4 neutrals,3 objections).The STAR evaluation(excluding 1 patient version of guideline)showed that none of the guidelines/expert consensus was with high quality,95.24%(20/21)with medium quality,and 4.76%(1/21)with low quality.Although there were many recommendations of acupuncture and moxibustion in the existing guidelines/expert consensus,there was great heterogeneity among the acupuncture and moxibustion treatment regimens.Moreover,most of the guidelines/expert consensus did not describe the details of acupuncture and moxibustion treatment regimens,such as acupuncture and moxibustion manipulation,acupoint selection,course and timing of treatment,which is difficult to guide the clinical practice of acupuncture and moxibustion.Conclusion:Developing clinical practice guidelines of acupuncture and moxibustion for chemotherapyand/or radiotherapy-induced nausea and/or vomiting according to the items of the STAR tool was urgent,so as to clarify the details of acupuncture and moxibustion regimens and provide standardized treatment regimens to guide the clinical practice of acupuncture and moxibustion.展开更多
基金Supported by National Natural Science Foundation of China:81973968,82274660China Center for Evidence Based Traditional Chinese Medicine:2020YJSZX-1.
文摘Background:Methodological issues and challenges hinder the high-quality development of acupuncture clinical studies.Objective:To systematically summarize the methodological issues,challenges,and recommendations in acupuncture clinical research using the participant,intervention,comparison,outcome,and study design(PICOS)framework to generate a comprehensive list of methodological questions and recommendations.Methods:We searched seven databases for articles on the methodological aspects of clinical acupuncture research from their inception to March 24,2023.Two researchers independently screened the titles,ab-stracts,and full text of each article.Data extraction and analyses were performed for the eligible studies.Finally,the methodological challenges and recommendations for acupuncture clinical studies are listed,and the frequency of methodological challenges is displayed in a sunburst chart.Results:A total of 226 studies were included in the review,most of which originated in China(173,77%),followed by the United States(25,11%)and the United Kingdom(12,5%).Clinical research on acupuncture faces methodological challenges that span the five elements of the PICOS framework.The most frequently mentioned issues were related to comparison,followed by study design and interven-tions.If further categorized,the establishment of the control group is undoubtedly the most concerning issue for researchers.Conclusion:This review provides a comprehensive overview of the challenges and recommendations for each aspect of the PICOS framework in clinical acupuncture research.
基金Supported by National Science Foundation Committee 81973964,82130122。
文摘Acupuncture is widely used for chronic pain with internationally recognized evidence [1].However,due to the large heterogeneity of acupuncture protocol,it is difficult to compare the effects related to factors such as acupoints,stimulation parameters,or depths of needling for chronic pain.
基金Supported by Innovation Fund of China Academy of Chinese Medical Sciences:CI2021A03503Fundamental Research Funds for the Central Public Welfare Research Institutes:ZZ13-024-9+1 种基金"The Belt and Road"TCM Cooperation Project of China Academy of Chinese Medical Sciences:GH201901China Center for Evidence Based Traditional Chinese Medicine:2020YJSZX-1。
文摘Objective:To summarize the available evidence of acupuncture for pain relief in the patients with postherpetic neuralgia(PHN)using a scoping review.Methods:Seven electronic databases of the original studies of acupuncture on PHN were retrieved.The search time was from the inception to May 1,2021.Two researchers screened the title,abstract and full text of each article independently.The original studies that was met the inclusion criteria were collected and analyzed,and finally presented with a qualitative description.Results:A total of 216 original studies were eligible and all of them were randomized controlled trials.The acupuncture therapies with the highest use frequency included manual acupuncture,pricking and cupping and electroacupuncture.Acupuncture therapies were mostly combined with other interventions in studies.There were large differences in acupoint selection,time duration for single treatment and the total treatment times.It was believed in all of the included studies that acupuncture was effective of pain relief in PHN and 85.65%of the studies obtained the minimum clinical importance difference(MCID),suggesting the clinical effectiveness.The adverse reaction of acupuncture was low in its incidence,and mostly transient in occurrence.Conclusion:The study type of acupuncture for PHN is relatively simple.Most studies show the advantages of acupuncture in pain relief of PHN.The quality of study needs to be improved.
基金Supported by National Natural Science Foundation of China:8197396882274660。
文摘Adequate preliminary research is a prerequisite for ensuring the quality of randomized controlled trials(RCTs)on acupuncture.This paper proposes that prior to conducting a new RCT of acupuncture,an evidence-based research(EBR)approach and exploratory studies should be adopted to ensure value and avoid waste of research.EBR,defined as using systematic reviews of relevant clinical studies and obtain the perspectives of end users in a systematic and transparent way to justify research questions and inform trial design,is recommended as the first step before embarking on an acupuncture RCT to ensure its value and rationality.The subsequent exploratory studies can aid researchers in pre-evaluating the effect of acupuncture treatment protocols,identifying key factors that influence the outcome,and test trial feasibility for protocol optimization.This article elucidates the significance and implementation of the EBR approach and exploratory studies,with the aim of providing practical methods to enhance the quality of acupuncture RCTs。
基金Supported by the (CACMS) Innovation Fund:C12021A03503National Natural Science Foundation of China:81973968+2 种基金China Center for Evidence Based Traditional Chinese Medicine,CCEBTCM:2020YJSZX-1"The Belt and Road" TCM Cooperation Project of China Academy of Chinese Medical Sciences:GH201901the Fundamental Research Funds for the Central Public Welfare Research Institutes:ZZ13-024-9。
文摘Objective:The body of research on acupuncture as a treatment strategy for fibromyalgia(FM)is steadily growing.This evidence map identifies,describes,and summarizes the current status of studies conducted to evaluate the efficacy of acupuncture for FM,identify research gaps,and provide information that could guide the design of future studies.Methods:Seven electronic databases–Cochrane Library,PubMed,Embase,China Biomedical Literature Database,VIP,Wanfang Database,and Chinese National Knowledge Infrastructure–were searched for relevant articles on acupuncture for FM.The search period was from the dates of inception of the databases to December 19,2022.Original clinical studies and systematic reviews on the use of acupuncture-related modalities for the treatment of FM were included.The basic information,quality assessments,and evidence maps of the included studies are presented as charts and bubble plots.The quality assessment tools used for evaluating the different types of studies included in the present study were Cochrane Collaboration’s tool,Canadian Institute of Health Economics quality appraisal tool,and A MeaSurement Tool to Assess systematic Reviews 2.Results:Fifty studies were included in this study.Of these,39(78.00%)were randomized controlled trials(RCTs),6(12.0%)were case series,and 5(10.0%)were systematic reviews.The included studies focused on manual acupuncture and conventional treatment in the treatment and control groups,respectively.The outcomes analyzed in the RCTs included pain(94.9%),sleep quality(46.2%),depression(46.2%),physical function(46.2%),stiffness(35.9%),well-being(35.9%),work status(35.9%),anxiety(33.3%),fatigue(33.3%),quality of life(17.9%),and overall effective rate(10.3%).The methodological quality of most of the studies was low or critically low regardless of the study design.In most studies,the therapeutic effect of acupuncture was significantly superior to that of the comparator.
基金Supported by China Academy of Chinese Medical Sciences Innovation FundC12021A03503National Natural Science Fund of China81973968+1 种基金Fundamental Research Funds for Central Public Welfare Scientific Research InstitutesZZ13-024-9"The Belt and Road"TCM Cooperation Project of China Academy of Chinese Medical Sciences in 2019GH201901。
文摘Background:Acupuncture is used to relieve symptoms,reducing recurrence,and improve the lives of patients with skin diseases.Objective:To identify,describe,and organize the available evidence on acupuncture for atopic eczema(AE)using evidence mapping of randomized controlled trials(RCTs),systematic reviews(SRs),and metaanalyses.Methods:We searched eight databases from inception to October 30,2021,for RCTs,SRs,and metaanalyses of acupuncture for patients with AE.Two reviewers screened the papers,before extracting the data and assessing the quality of the included studies.The basic and clinical characteristics,and quality of assessment of the studies were assessed using descriptive statistics and qualitative analyses.A bubble plot was used to visualize the evidence map to indicate the relationship between the type and frequency of outcomes,the quality and overall effects of acupuncture,and the outcomes of the studies.Results:Forty-five studies(Forty RCTs,five SRs,and meta-analyses)were included.The number of publications increased rapidly after 2013 and peaked in 2019.The most frequently applied intervention was one type of acupuncture therapy.The most frequent comparison was between acupuncture and active medicine.The symptomatic outcome was the most commonly used,and the quality of the included studies was relatively low.All included studies showed a significantly better outcome in the acupuncture group compared to the control group(P<0.05).Most outcomes in the included studies were of low or critically low quality.Several symptomatic outcomes and health-related quality of life outcomes in the included RCTs indicated moderate quality,while some symptomatic outcomes and global symptom improvement in the included SRs and meta-analyses indicated low quality.Conclusion:The majority of studies related to acupuncture for AE indicated promising results,but with relatively low quality;thus,further studies with more robust designs should be conducted to validate the results.
基金Supported by China Academy of Chinese Medical Sciences(CACMS)Innovation Fund:CI2021A03503National Key Research and Development Program:2022YFC3500705Fundamental Research Funds for the Central Public Welfare Research Institutes:ZZ20211810。
文摘Objective:To summarize and analyze the recommendations of acupuncture and moxibustion in the global guidelines/expert consensus of chemotherapy-and/or radiotherapy-induced nausea and/or vomiting,providing a basis for the development of clinical practice guidelines on acupuncture and moxibustion for chemotherapy-and/or radiotherapy-induced nausea and/or vomiting.Methods:We systematically searched 7 comprehensive databases,7 guideline libraries and 4 websites of societies/associations.The retrieval period was from the inception to April 1,2023.Two researchers independently screened the literature,extracted data,and used the Scientific,Transparent,and Applicable Rankings(STAR)tool to evaluate the quality of guidelines/expert consensus that contained acupuncture and moxibustion recommendations,and analyzed acupuncture and moxibustion recommendations in guidelines/expert consensus and their evidence base.Results:A total of 56 guidelines/expert consensus related to the prevention and treatment of chemotherapy-and/or radiotherapy-induced nausea and/or vomiting were included,and 22 guidelines/expert consensus contained acupuncture and moxibustion recommendations,with a total of 34 recommendations on acupuncture and moxibustion(27 supports,4 neutrals,3 objections).The STAR evaluation(excluding 1 patient version of guideline)showed that none of the guidelines/expert consensus was with high quality,95.24%(20/21)with medium quality,and 4.76%(1/21)with low quality.Although there were many recommendations of acupuncture and moxibustion in the existing guidelines/expert consensus,there was great heterogeneity among the acupuncture and moxibustion treatment regimens.Moreover,most of the guidelines/expert consensus did not describe the details of acupuncture and moxibustion treatment regimens,such as acupuncture and moxibustion manipulation,acupoint selection,course and timing of treatment,which is difficult to guide the clinical practice of acupuncture and moxibustion.Conclusion:Developing clinical practice guidelines of acupuncture and moxibustion for chemotherapyand/or radiotherapy-induced nausea and/or vomiting according to the items of the STAR tool was urgent,so as to clarify the details of acupuncture and moxibustion regimens and provide standardized treatment regimens to guide the clinical practice of acupuncture and moxibustion.
