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The Acupuncture Evidence Project: A Comparative Literature Review

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Background The acupuncture evidence project investigated the state of the evidence regarding acupuncture, with the focus on systematic reviews and meta-analyses. The Australian Department of Veterans’ Affairs 2010 Alternative Therapies Review and United States Department of Veterans Affairs Acupuncture Evidence Map 2014 were used as baselines, then evidence levels were updated to reflect subsequent research. Methods A search of PubMed and Cochrane Library for systematic reviews and meta-analyses from March 2013 to September 2016 was conducted. Three reviews from October 2016 to January 2017 were also included. Evidence levels were graded using NHMRC levels. Risk of bias was assessed using the Cochrane GRADE system where possible. All results were displayed in tables to demonstrate changes in evidence level over time, as well as the current state of evidence by clinical area. Results Of the 122 conditions reviewed, evidence of effect was found at various levels for 117 conditions. Five conditions were assessed as ‘no evidence of effect’. The level of evidence had increased for 24 conditions since the previous reviews. The findings of this review are limited by the mounting evidence that sham/placebo controls used in acupuncture trials are not inert, which is likely to lead to a consistent underestimation of the true effect size of acupuncture interventions. Conclusions Systematic reviews published up to January 2017 indicate that acupuncture has a ‘positive effect’ on eight conditions (migraine prophylaxis, headache, chronic low back pain, allergic rhinitis, knee osteoarthritis, chemotherapy-induced nausea and vomiting, post-operative nausea and vomiting and post-operative pain), ‘potential positive effect’ on a further 38 conditions, ‘unclear/insufficient evidence’ for 71 conditions and ‘no evidence of effect’ for five conditions. Evidence of cost-effectiveness was identified for 10 conditions, and evidence for safety was identified for nine conditions.
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... Recommendations for the modified RCT approach suggested that acupuncture studies follow designs along the efficacy -effectiveness research continuum (Witt, 2011). Efficacy studies more closely adhere to the aims of the standardised placebo RCT design, whereby the most likely active treatment components (Fønnebø et al., 2007), are tested under ideal conditions (McDonald & Janz, 2017;Witt, 2011), to determine whether acupuncture is superior to placebo (MacPherson et al., 2008). The rationale behind this approach, is ease of replication, interpretation, and reliability of results, with studies of this type being referred to as having high internal validity (Witt, 2011). ...
... Widespread implementation of these recommendations has resulted in more appropriately designed efficacy and effectiveness trials that have provided a consensus about which medical conditions acupuncture can assist (Birch, Keppel, Jonkman, Hekker, & Bos, 2004;McDonald & Janz, 2017;Witt, 2011). In addition, a body of evidence has accumulated that supports that when acupuncture is applied as an adjunct therapy, it is "more effective than routine care alone", and is of acceptable cost-effectiveness (Witt, 2011). ...
... Overall, the described benefits to mood, ability to cope, energy, motivation, and personal relationships were congruent with those reported to have occurred in 228 157 surveyed participants with serious mental illness after receiving acupuncture, and other CM approaches (Russinova et al., 2002). Similarly, broader ranging improvements across physical, psychological and social domains have also been reported in case studies, qualitative and mixed methods investigations and systematic reviews assessing acupuncture effects in general populations (Finston, 2009;Gould & MacPherson, 2001;Grant & Cochrane, 2014;Greene Prabhu, Walsh, Sirois, & McCaffrey, 2009;Lee et al., 2012;McDonald & Janz;Paterson et al., 2011;Paterson, Unwin, & Joire, 2010;Reshef et al., 2013;Rugg, Paterson, Britten, Bridges, & Griffiths, 2011;Smith, Ussher, Perz, Carmady, & de Lacey, 2011). ...
Thesis
A mixed-methods study evaluating the effects of acupuncture as an adjunct intervention for antenatal depression.
... 9 Akupunktur uygulamalarının endikasyonları Tablo 1'de yer almaktadır. 10 Bu endikasyonları ile uygulanan akupunkturun etkilerin yanı sıra uygulama kaynaklı lokal reaksiyon, pnömo-toraks, vazovagal refleks, infeksiyon ve yabancı cisim granülomu gibi komplikasyonlarda meydana gelebilmektedir. 11 Akupunktur uygulamalarının kontrendikasyonları Tablo 2'de yer almaktadır. ...
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Akupunktur ameliyat öncesi ve sonrası dönemde semptomların kontrol altına alınmasında kullanılan vücuttaki belirli noktalara küçük iğneler veya bası/basınç uygulama ilkesine dayanan farmakolojik olmayan bir tedavi seçeneğidir. Akupunktur/akupresur uygulamaları ile analjezik, sedatif, homeostatik, immünstimülan etki ve motor fonksiyonlarda iyileşme gibi etkiler sağlanmaktadır. Ameliyat öncesi akupunktur/akupresur uygulamaları ameliyat öncesi anksiyeteyi azalttığı, analjeziyi arttırdığı, anestezik tüketimini azalttığı ve ameliyat sonrası dönemde bulantı-kusma gibi komplikasyonları azalttığı görülmektedir. Ameliyat sonrası dönemde ise akupunktur/akupresur uygulamaları ile ameliyat sonrası bulantı kusmanın engellenmesi ve ameliyat sonrası opioid kullanımının azaltılması ile birlikte ağrı tedavisinde adjuvan tedavi olarak kullanılması önerilmektedir.
... A brief review using all systematic reviews and metadata described acupuncture as having a 'potentially important role as part of a treatment plan for migraine, tension-type headache, and several different types of chronic headache disorders (Coeytaux & Befus, 2016). Studies in Germany and the UK have found that acupuncture for chronic headaches to be cost-effective (McDonald & Janz, 2017). Further, Ehler & Kraya, (2020) evaluated the efficacy of acupuncture for migraine among children and adolescents. ...
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Abstract Introduction: Auriculotherapy (AA) could support standard treatment for anxiety disorders (AD), but its effectiveness and safety remain undetermined. The aim of this systematic review was to determine whether AA was effective and safe for treating people with AD. Methods: Searches were conducted on eight databases for randomized controlled trials (RCT) evaluating the effectiveness and safety of AA compared with placebo, waiting list treatment, routine care, or alternative treatment. Searches were run from inception until the 30th of June 2021. Methodological quality of included studies was assessed using the Cochrane risk of bias assessment tool and quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool. Meta-analyses were conducted using statistical software RevMan V5.4. The protocol was published and registered PROSPERO ID: CRD42021254503. Results: Thirteen trials met the inclusion criteria for quality and of these nine were included in the meta-analysis. AA (n=386) reduced anxiety levels compared with placebo (n=382) standardized mean difference (SMD): -0.44 95% of Confidence Intervals (CI) [-0.60, -0.28], 9 studies, for AA compared with a waiting list (n=360), 8 studies SMD (-0.55; 95% CI [-0.70, -0.41]). Certainty was graded as moderate and with unlikely publication bias. There was moderate certainty of evidence for an AA (n=130) intervention for pre-operatory anxiety levels when compared with placebo (n=129) SMD -1.40 95% CI [-2.54, -0.26], 3 studies and when compared with a waiting list group (n=98) Mean difference (MD) -5.02 95% CI [-8.15, -1.90], 2 studies. Few studies reported adverse events and other important secondary outcomes such as salivary cortisol and vital signs. Conclusion: AA may be effective as a complementary treatment for situational anxiety. There is still an evidence gap regarding its safety and efficacy. The type and frequency of AA used for anxiety treatment requires further exploration.
Article
Background: Acupuncture may be of use for treating the various clusters of symptoms occurring after a stroke. Evidence used to underpin clinical practice and treatment guidelines (CPGs and TGs respectively) varies from country to country and may affect what recommendations are made by guideline developers. Purpose: To examine the extent to which international clinical and treatment guidelines on post-stroke treatment mention the role of acupuncture and to identify what symptoms they recommend for its use. Method: Scoping of national and international websites of clinical practice and treatment guidelines (CPGs and TGs respectively) on the after care and rehabilitation of stroke patients provided by professional and government organisations was conducted. The presence/absence of recommendations and the underpinning evidence was appraised for the use of acupuncture for symptoms following stroke. Results: Of 84 CPGs and TGs on post stroke after-care identified from 27 countries between 2001- 2021, 49 making statements about acupuncture. Positive recommendations on the use of acupuncture were identified for 15 symptom areas from 11 countries for: stroke rehabilitation, dysphagia, shoulder pain, motor recovery, walking, balance, spasticity, upper limb extremity impairment, post-stroke pain, central post stroke pain, cognitive disorder, depression, and sleep problems. Thirty-five CPGs (2001-2018) from 18 countries published over the same period were identified that made no mention of acupuncture and therefore no recommendations were made on its use. Conclusions: Currently, evidence used by international guideline developers varies and this influences whether a positive or negative recommendation is made. Recommendations to use acupuncture should be based on the best available evidence which has been quality appraised.
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To illustrate the novelties in integrative and complementary medicine in 2021, the authors present a selection of six articles. One of them is specifically related to COVID-19. The other articles deal with themes that are always relevant and where complementary approaches represent a real added value. Two articles focus on low back pain, a common problem in primary care medicine. The others examine acupuncture in the oncological context, the use of therapeutic suggestions in an operative context, and Tai Chi. The authors thus provide an overview of the range of possible complementary therapeutic approaches that are increasingly supported by evidence, inviting them to be better integrated into clinical practice.
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Background: Acupuncture is practiced in many Western countries with increasing evidence supporting its use across the healthcare system. However, this nonpharmacological intervention is yet to be widely integrated into hospitals. Fundamental to the integration of any innovation into healthcare systems is the attitudes of healthcare professionals. Aims: To explore healthcare professionals' attitudes towards acupuncture and identify the enablers and barriers to integration in the hospital setting. Design: This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines; we conducted a mixed-method systematic review following Joanna Briggs Institute Reviewer's Manual 2017. Data sources: PubMed, CINAHL, AMED, EMBASE, Cochrane Library, and SCOPUS were searched from their inception to December 2019 using different combination of keywords. Methods: Attitude and perception data were extracted from the articles and constructs were categorized as barriers and enablers. A convergent integrated approach was adopted whereby qualitative data themes were integrated with quantitative data constructs to generate descriptive codes around enablers and barriers at intrapersonal, interpersonal, and environmental levels according to the framework proposed by Manias et al. (2014). Results: Twenty-six studies comprising 19 survey and seven interview studies were identified, with 24 articles (92%) reporting positive attitudes, supporting the integration of acupuncture into Western medicine. Enablers identified were prior positive experience, belief in the treatment's efficacy, and patient demand. Barriers were lack of evidentiary knowledge or experience; lack of resources such as time, providers, and funding; and paradigm differences. Twenty studies (77%) focused on medical doctors or medical student perceptions. A conceptual framework for implementing and integrating acupuncture into Western medicine is proposed. Conclusion: Healthcare professionals' attitudes to acupuncture are positive. Barriers to integrating acupuncture into the hospital system exist at intrapersonal, interpersonal, and external levels, with lack of resources being the key barrier. Nurses' role in facilitating integration into Western medical pain management practice provides an avenue for future research. The proposed conceptual framework provides guidance for nursing researchers interested in the role of acupuncture and integrated medicine in patient-centric, value-based healthcare.
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Background Health inequities or disparities challenge governments and public health systems, impacting health service delivery worldwide. Inherent disadvantage linked to the social determinants of health is intrinsic to the health outcomes among society’s marginalised and most vulnerable members. It is acknowledged that marginalised individuals present with higher levels of chronic disease, multi-morbidities and adverse health behaviours than their non-disadvantaged peers. Marginalised individuals and communities present with complex health problems and often receive poor quality or inadequate health care that is unable to meet their needs, leading to stigmatisation and perpetuating the cycle of disadvantage. Discussion Emerging research indicates that there may be a role for acupuncture in managing the health needs of marginalised populations and that when historical barriers to accessing acupuncture treatment (such as awareness, availability and affordability of this therapy) are removed, certain marginalised populations are open to engaging with acupuncture treatment. Acupuncture has been used by low-income, refugee, veteran and ethnic minority groups to manage chronic pain, substance use disorders, stress and the impacts of trauma in conventional health settings such as community clinics and hospitals. There is the suggestion that integrative health settings and group treatment models may improve access and uptake of acupuncture among marginalised groups. Conclusion Evidence suggests that the sociodemographic profile of acupuncture users is diverse and acupuncture therapy holds potential value in the treatment of marginalised populations. Further research that investigates reframing and expanding the scope of practice for acupuncture is timely and may contribute to tackling health inequity.
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Eden Energy Medicine (EEM) is a hands-on healthcare approach providing assessments and interventions that focus on the body's electromagnetic and more subtle energy systems. More than 1600 certified practitioners have completed an intensive 2-year training program in the method, and these practitioners have brought the approach to hundreds of thousands of people in individual sessions and self-care classes. In this article, the method's founders briefly trace its development and present illustrative case histories. They then address a number of questions that are pertinent for any approach to energy medicine from the perspective of their experiences advancing EEM. Broader acceptance of energy medicine has been impeded by the field's emphasis on energies with purported properties not known in the energies that fall along the electromagnetic spectrum. Such assertions challenge conventional concepts within Western medicine. The anomalies can, however, be explained by a framework that is informed by an understanding of subtle energies as conceived in healing systems from myriad cultures dating back thousands of years. The authors present empirical evidence that supports the validity of the subtle energy concept, propose health-related implications of such energies, and present 9 discrete energy systems emphasized by EEM. They also review the clinical efficacy of energy medicine treatments. Finally, they describe 6 advantages of an energy-informed approach to healthcare. Among these are an ability to address biological activities at their energetic foundations; the regulation of physiological processes with speed and precision; and the promotion of healing and prevention of illness with interventions that can be economically and noninvasively applied.
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Objectives: The aim of this systematic review was to assess the evidence from randomised controlled trials (RCTs) on the efficacy, effectiveness and safety of acupuncture in women with polycystic ovarian syndrome (PCOS) undergoing in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). Methods: We searched a total of 15 databases through October 2015. The participants were women with PCOS (diagnosed using the Rotterdam criteria) undergoing IVF or ICSI. Eligible trials were those with intervention groups receiving manual acupuncture (MA) or electroacupuncture (EA), and control groups receiving sham acupuncture, no treatment or other treatments. Outcomes included the clinical pregnancy rate (CPR), live birth rate (LBR), ongoing pregnancy rate (OPR) and incidence of ovarian hyperstimulation syndrome (OHSS) and adverse events (AEs). For statistical pooling, the risk ratio (RR) and its 95% (confidence interval) CI was calculated using a random effects model. Results: Four RCTs including 430 participants were selected. All trials compared acupuncture (MA/EA) against no treatment. Acupuncture significantly increased the CPR (RR 1.33, 95% CI 1.03 to 1.71) and OPR (RR 2.03, 95% CI 1.08 to 3.81) and decreased the risk of OHSS (RR 0.63, 95% CI 0.42 to 0.94); however, there was no significant difference in the LBR (RR 1.61, 95% CI 0.73 to 3.58). None of the RCTs reported on AEs. Conclusions: Acupuncture may increase the CPR and OPR and decrease the risk of OHSS in women with PCOS undergoing IVF or ICSI. Further studies are needed to confirm the efficacy and safety of acupuncture as an adjunct to assisted reproductive technology in this particular population.
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Purpose: Controversial results have been reported concerning the effect of acupuncture on in vitro fertilization (IVF) outcomes. The current review was conducted to systematically review published studies of the effects of acupuncture on IVF outcomes. Methods: Women undergoing IVF in randomized controlled trials (RCTs) were evaluated for the effects of acupuncture on IVF outcomes. The treatment groups involved traditional, electrical, laser, auricular, and other acupuncture techniques. The control groups consisted of no, sham, and placebo acupuncture. The PubMed, Embase, and Web of Science databases were searched. The pregnancy outcomes data are expressed as odds ratios (ORs) with 95% confidence intervals (CIs) based on a fixed model or random model depending on the heterogeneity determined by the Q test and I2 statistic. The major outcomes were biochemical pregnancy rate (BPR), clinical pregnancy rate (CPR), live birth rate (LBR), and ongoing pregnancy rate (OPR). Heterogeneity of the therapeutic effect was evaluated by a forest plot analysis, and publication bias was assessed by a funnel plot analysis. Results: Thirty trials (a total of 6344 participants) were included in this review. CPR data showed a significant difference between the acupuncture and control groups (OR 1.26, 95% CI 1.06-1.50, p = 0.01), but there was significant statistical heterogeneity among the studies (p = 0.0002). When the studies were restricted to Asian or non-Asian area trials with a sensitivity analysis, the results significantly benefited the CPR in Asian group (OR 1.51, 95% CI 1.04-2.20, p = 0.03). Based on the area subgroup analysis, we found that in the Asian group, the IVF outcomes from the EA groups were all significantly higher than those from the control groups (CPR: OR 1.81, 95% CI 1.20-2.72, p = 0.005; BPR: OR 1.84, 95% CI 1.12-3.02, p = 0.02; LBR: OR 2.36, 95% CI 1.44-3.88, p = 0.0007; OPR: OR 1.94, 95% CI 1.03-3.64, p = 0.04). Meanwhile, compared with other acupuncture time, the IVF outcome results were significantly superior in the acupuncture group when acupuncture was conducted during controlled ovarian hyperstimulation (COH) (CPR: OR 1.71, 95% CI 1.27-2.29, p = 0.0004; LBR: OR 2.41, 95% CI 1.54-3.78, p = 0.0001; BPR: OR 1.50, 95% CI 1.02-2.20, p = 0.04; OPR: OR 1.88, 95% CI 1.06-3.34, p = 0.03). However, when acupuncture was conducted at the time of embryo transfer, the BPR and OPR from the acupuncture groups were significantly lower than those of the controls in the Asian group (BPR: OR 0.67, 95% CI 0.48-0.92, p = 0.01; OPR: OR 0.68, 95% CI 0.49-0.96, p = 0.03). Conclusions: Based on an analysis of the studies, acupuncture improves the CPR among women undergoing IVF. When the studies were restricted to Asian or non-Asian area patients, compared with traditional acupuncture and other methods, electrical acupuncture yielded better IVF outcomes. Optimal positive effects could be expected using acupuncture in IVF during COH, especially in Asian area. However, as a limitation of this review, most of the included studies did not mention the number of embryos transferred.
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Objective: To evaluate the long-term benefit of providing a post-acute outpatient group exercise program for patients following primary total knee replacement (TKR) surgery for osteoarthritis. Methods: A multicenter randomized clinical trial conducted in 12 Australian public and private hospital centers. A total of 422 participants, aged 45 to 75 years, were randomly allocated prior to hospital discharge to the post-acute group exercise program or usual care and were assessed six weeks, six months and 12 months after surgery. The main outcomes were operated knee pain and activity limitations at 12 months using the WOMAC questionnaire. Secondary outcomes included health-related quality of life (SF-12), knee extension and flexion strength, stair-climb power, 50-foot walk speed and active knee range of motion. Results: While both allocation groups achieved significant improvements in knee pain and activity limitations over the 12-month follow-up period, there were no significant differences in these main outcomes, or in the secondary physical performance measures, between the two treatment allocations. Twelve months after TKR, 69% and 72% of participants allocated to post-acute exercise and usual acute care, respectively, were considered to be treatment-responders. While population normative values for self-report measures of pain, activity limitation and health-related quality of life were attained 12 months after TKR, marked deficits in physical performance measures remained. Conclusions: Providing access to a post-acute group exercise program did not result in greater reductions in long-term knee pain or activity limitations than usual care. Patients undergoing primary TKR retain marked physical performance deficits 12 months after surgery. This article is protected by copyright. All rights reserved.
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Health care in the USA faces a double challenge, the crisis of chronic pain and the crisis of opioid misuse and overdose. Patients have been prescribed opioids at high doses with unclear indications for long periods of time, putting them at high risk for morbidity and mortality. A significant proportion of these patients have comorbid psychiatric or substance use disorders complicating their pain conditions. The challenges to treating these patients adequately are discussed, along with potential solutions to these issues at the level of the individual provider, healthcare systems, and society.
Article
OBJECTIVE: To systematically review the Chinese-language literature on acupuncture-related adverse events. METHODS: We searched three Chinese databases (the Chinese Biomedical Literature Database, 1980-2009; the Chinese Journal Full-Text Database, 1980-2009; and the Weipu Journal Database, 1989-2009) to identify Chinese-language articles about the safety of traditional needle acupuncture. Case reports, case series, surveys and other observational studies were included if they reported factual data, but review articles, translations and clinical trials were excluded. FINDINGS: The inclusion criteria were met by 115 articles (98 case reports and 17 case series) that in total reported on 479 cases of adverse events after acupuncture. Fourteen patients died. Acupuncture-related adverse events were classified into three categories: traumatic, infectious and "other". The most frequent adverse events were pneumothorax, fainting, subarachnoid haemorrhage and infection, while the most serious ones were cardiovascular injuries, subarachnoid haemorrhage, pneumothorax and recurrent cerebral haemorrhage. CONCLUSION: Many acupuncture-related adverse events, most of them owing to improper technique, have been described in the published Chinese literature. Efforts should be made to find effective ways of monitoring and minimizing the risks related to acupuncture.
Article
Background Neck pain is one of the three most frequently reported complaints of the musculoskeletal system. Treatments for neck pain are varied, as are perceptions of benefit. Acupuncture has been used as an alternative to more conventional treatment for musculoskeletal pain. This review summarises the most current scientific evidence on the effectiveness of acupuncture for acute, subacute and chronic neck pain. This update replaces our 2006 Cochrane review update on this topic. Objectives To determine the effects of acupuncture for adults with neck pain, with focus on pain relief, disability or functional measures, patient satisfaction and global perceived effect. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Manual, Alternative and Natural Therapy Index System (MANTIS), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the Index to Chiropractic Literature (ICL) from their beginning to August 2015. We searched reference lists, two trial registers and the acupuncture database Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS) in China to 2005. Selection criteria We included published trials that used random assignment to intervention groups, in full text or abstract form. We excluded quasirandomised controlled trials (RCTs). Data collection and analysis Two review authors made independent decisions for each step of the review: article inclusion, data abstraction and assessment of quality of trial methods. We assessed study quality by using the Cochrane Back Review Group ’Risk of bias’ tool. We used consensus to resolve disagreements, and when clinical heterogeneity was absent, we combined studies by using random-effects meta-analysis models. Main results Of the 27 included studies, three represented individuals with whiplash-associated disorders (WADs) ranging from acute to chronic (205 participants), five explored chronic myofascial neck pain (186 participants), five chronic pain due to arthritic changes (542 participants), six chronic non-specific neck pain (4,011 participants), two neck pain with radicular signs (43 participants) and six subacute or chronic mechanical neck pain (5,111 participants). For mechanical neck pain, we found that acupuncture is beneficial at immediate-term follow-up compared with sham acupuncture for pain intensity; at short-term follow-up compared with sham or inactive treatment for pain intensity; at short-term follow-up compared with sham treatment for disability; and at short-term follow-up compared with wait-list control for pain intensity and neck disability improvement. Statistical pooling was appropriate for acupuncture compared with sham for short-term outcomes due to statistical homogeneity (P value = 0.83; I² = 20 %). Results of the meta-analysis favoured acupuncture (standardised mean difference (SMD) – 0.23, 95 % confidence interval (CI) –0.20 to –0.07; P value = 0.0006). This effect does not seem sustainable over the long term. Whether subsequent repeated sessions would be successful was not examined by investigators in our primary studies. Acupuncture appears to be a safe treatment modality, as adverse effects are minor. Reported adverse effects include increased pain, bruising, fainting, worsening of symptoms, local swelling and dizziness. These studies reported no life-threatening adverse effects and found that acupuncture treatments were cost-effective. Since the time of our previous review, the quality of RCTs has improved, and we have assessed many of them as having low risk of bias. However, few large trials have provided high-quality evidence. Authors’ conclusions Moderate-quality evidence suggests that acupuncture relieves pain better than sham acupuncture, as measured at completion of treatment and at short-term follow-up, and that those who received acupuncture report less pain and disability at short-term follow-up than those on a wait-list. Moderate-quality evidence also indicates that acupuncture is more effective than inactive treatment for relieving pain at short-term follow-up.
Article
Background Insomnia is a highly prevalent health complaint in the modern societies; however, insomnia remains under-diagnosed and under-treated. Although screening tools, including the Insomnia Severity Index (ISI), Athens Insomnia Scale (AIS), and Pittsburg Sleep Quality Index (PSQI), are widely used for assessing the risk of insomnia, the diagnostic properties have yet to be summarized in a systematic manner. Objectives To estimate and to compare the diagnostic accuracy of the ISI, AIS, and PSQI for insomnia screening. Data sources We systematically searched EMBASE, PubMed, PsycINFO, CINAHL and Chinese Electronic Periodic Services for data from their inception to May 20, 2015. Data selection Original articles that had assessed the sensitivity and specificity of the ISI, AIS, or PSQI against a reference standard in adult participants (age > 18) were included. Results A total of 19 studies comprising 4693 participants were included. The pooled sensitivity for the ISI, AIS, and PSQI was 88% (95% confidence interval [CI] = 0.79 to 0.93), 91% (0.87 to 0.93), and 94% (0.86 to 0.98), respectively. The pooled specificity was 85% (0.68 to 0.94), 87% (0.68 to 0.95), and 76% (0.64 to 0.85); and the pooled DORs was 41.93 (8.77 to 200.33), 67.7 (23.4 to 196.1), and 53 (15.5 to 186.2), respectively. The summary estimates did not differ significantly among the ISI, AIS and PSQI (all P > 0.05). Conclusions The current evidence indicates that the ISI, AIS, and PSQI yield comparable diagnostic properties for insomnia screening.