Article type
Year
Abstract
Background: Well-designed multicenter randomized controlled clinical trials (RCTs), systematic reviews and meta-analysis could just assess two interventions treating the same disease. However, when there are more than two treatments for the same disease, direct comparisons between each treatment should not be forgotten. Network meta-analysis (NMA) aims to compare and estimate the pair wise effect sizes of variety of treatments for the same disease simultaneously when there is a lack of sufficient evidence from direct comparisons.
Objectives: To evaluate the application of NMA in the therapeutic evaluation of acupuncture therapy for the treatment of diabetic peripheral neuropathy (DPN), and to apply NMA to acupuncture therapy and traditional Chinese medicine.
Methods: We searched the following databases to September 2014: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, CNKI, VIP, Wanfang, and SinoMed. After including RCTs of acupuncture therapy for DPN, we performed NMA and drew network plots through GeMTC R package and WinBUGS software based on the Bayesian statistical model and Markov Chain Monte Carlo method (MCMC).
Results: Our research involved seven treatments (manual acupuncture, electro-acupuncture, tapping, needle warming moxibustion, mecobalamin, no treatment and vitamin B1 and B12) in 40 trials, and a total of 2602 participants. The network plot drawn by R software through calling the GeMTC R package has been appended to the attachments. The Rank probability showed that four types of included acupuncture therapy all had beneficial effects on global improvement, especially tapping, which displayed the best efficacy, and needle warming moxibustion which followed it. However, the poor quality of the methodology may lead to a need to be more cautious when interpreting these positive findings.
Conclusions:The results may provide valid certified clinical evidences of acupuncture therapy for the treatment of diabetic peripheral neuropathy as well as the feasible solution for the methodological issues in the NMA, which can help to establish a reference model therapeutic evaluation of traditional Chinese medicine.
Objectives: To evaluate the application of NMA in the therapeutic evaluation of acupuncture therapy for the treatment of diabetic peripheral neuropathy (DPN), and to apply NMA to acupuncture therapy and traditional Chinese medicine.
Methods: We searched the following databases to September 2014: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, CNKI, VIP, Wanfang, and SinoMed. After including RCTs of acupuncture therapy for DPN, we performed NMA and drew network plots through GeMTC R package and WinBUGS software based on the Bayesian statistical model and Markov Chain Monte Carlo method (MCMC).
Results: Our research involved seven treatments (manual acupuncture, electro-acupuncture, tapping, needle warming moxibustion, mecobalamin, no treatment and vitamin B1 and B12) in 40 trials, and a total of 2602 participants. The network plot drawn by R software through calling the GeMTC R package has been appended to the attachments. The Rank probability showed that four types of included acupuncture therapy all had beneficial effects on global improvement, especially tapping, which displayed the best efficacy, and needle warming moxibustion which followed it. However, the poor quality of the methodology may lead to a need to be more cautious when interpreting these positive findings.
Conclusions:The results may provide valid certified clinical evidences of acupuncture therapy for the treatment of diabetic peripheral neuropathy as well as the feasible solution for the methodological issues in the NMA, which can help to establish a reference model therapeutic evaluation of traditional Chinese medicine.