Reporting characteristics and quality of systematic reviews on acupuncture analgesia

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Authors
Li X1, Shang W1, Wei L1, Zhang J1, Yang K1
1Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, China
Abstract
Background: Acupuncture is frequently used for pain treatment. However, verifying its efficacy and safety may need high-quality evidence.
Objectives: Based on the principles of evidence-based medicine to explore and show the reporting characteristics as well as quality of the systematic reviews (SRs) on acupuncture analgesia.
Methods: We searched four international databases (PubMed, the Cochrane Library, Embase, Web of Science), three Chinese databases (CBM, CNKI, WANFANG) and relevant websites in January 2016. The search terms were 'Acupuncture', 'Needle', 'Auricular', 'Electroacupuncture', 'Electro-acupuncture', 'Acusector', 'Pain', 'Analgesia', 'Systematic Review', 'Meta'. We used EndNote X4 and Excel for data description and analysis, and AMSTAR (A MeaSurement Tool to Assess systematic Reviews) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statements to assess quality of the included SRs.
Results: A total of 109 SRs met the inclusion criteria: publication ranged from one in 1997 to 15 in 2015. Only 17% of the publications were Cochrane SRs (CSRs), and 94% were from SCI (Science Citation Index) journals with impact factors from 0.5 to 18. The UK had the most publications, followed by USA and China. Low back pain, headache, cancer pain, labor pain and MPS were the most common conditions. Nearly 73% of the SRs conducted meta-analysis, 53% used RevMan software to analyze data, 44% used the Cochrane 'Risk of bias' tool to evaluate quality, 58% had positive results, and only 9% reported being updates. After AMSTAR and PRISMA were released, scores for some items improved, but only a few SRs fulfilled the criteria “assessed the likelihood of publication bias”, “protocol and registration” and “additional analyses”. CSRs were of better quality than non-CSRs, and journal categories made no difference to quality.
Conclusions: Although the quantity and quality of SRs on acupuncture analgesia has been promoted in recent years, CSRs form a minority of those available. More efforts on assessing the publication bias, providing protocol and registration, offering additional analyses, etc. are needed to improve the validity of the SRs.