Impact of including Korean RCTs in Cochrane reviews of acupuncture

Poster
2012 Auckland
Kim KH1, Kong JC2, Choi J3, Choi T4, Shin B5, McDonald S6, Lee MS4
1Department of Acupuncture and Moxibustion, Korean Medicine Hospital, Yangsan, South Korea
2Department of Rehabilitation Medicine, College of Korean Medicine, Wonkwang University, Iksan, South Korea
3Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan, South Korea
4Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
5Department of Rehabilitation Medicine, School of Korean Medicine, Pusan National University, Yangsan, South Korea
6Australasian Cochrane Centre, Monash University, Melbourne, VIC 3168, Australia

Background:

Acupuncture is commonly practiced in Korea and is regularly evaluated in clinical trials. Although many Cochrane reviews of acupuncture include searches of both English and Chinese databases, there is no information on the value of searching Korean databases.

Objectives:

This study aimed to investigate the impact of searching Korean databases and journals for trials eligible for inclusion in existing Cochrane acupuncture reviews.

Methods:

We searched 12 Korean databases and seven Korean journals to identify randomised trials meeting the inclusion criteria for acupuncture reviews in CDSR. We compared risk of bias assessments of the Korean trials with the trials included in the Cochrane acupuncture reviews. Where possible, we added data from the Korean trials to the existing meta-analyses in the relevant Cochrane review and conducted sensitivity analyses to test the robustness of the results.

Results:

Sixteen Korean trials (involving 742 participants) met the inclusion criteria for the 8 Cochrane acupuncture reviews (125 trials; 13 041 participants). Inclusion of the Korean trials provided data for 20% of existing meta-analyses (24 out of 120) and generated seven new ones. Inclusion of the Korean trials did not change the direction of effect in any of the meta-analyses. The effect size and heterogeneity remained mostly unchanged. In only one meta-analysis did the significance change. Compared to the studies included in the Cochrane acupuncture reviews, the risk of bias in the Korean trials was higher in terms of outcome assessor blinding (p = 0.0136) but similar for allocation concealment (p = 0.1192).

Conclusions:

Many Korean studies contributed additional data to the existing meta-analyses in Cochrane acupuncture reviews. Although inclusion of these studies did not alter the results of the meta-analyses, comprehensive searches of the literature are important to avoid potential language bias. The identification and inclusion of eligible Korean trials should be considered for reviews of acupuncture.