Advertisement

Reporting and methodological quality of acupuncture network meta-analyses could be improved: an evidence mapping

  • Yan Wang
    Affiliations
    Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China

    Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
    Search for articles by this author
  • Nan Chen
    Affiliations
    Research and Education Department, Shaanxi Provincial Rehabilitation Hospital, Xi'an, China
    Search for articles by this author
  • Kangle Guo
    Affiliations
    Gansu Provincial Hospital, Lanzhou, China
    Search for articles by this author
  • Yanfei Li
    Affiliations
    Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China

    Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
    Search for articles by this author
  • Fenfen E
    Affiliations
    Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China

    Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
    Search for articles by this author
  • Chaoqun Yang
    Affiliations
    Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China

    Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
    Search for articles by this author
  • Xue Shang
    Affiliations
    Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China

    Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
    Search for articles by this author
  • Xiuxia Li
    Correspondence
    Correspondence to: Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou 730000, China. Tel.: +86 138 9362 4871; fax: +86 138 9311 7077.
    Affiliations
    Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China

    Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
    Search for articles by this author
  • Kehu Yang
    Correspondence
    Correspondence to: Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou 730000, China. Tel.: +86 138 9362 4871; fax: +86 138 9311 7077.
    Affiliations
    Evidence-Based Social Science Research Center & Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China

    Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China

    Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
    Search for articles by this author
Published:November 06, 2022DOI:https://doi.org/10.1016/j.jclinepi.2022.11.004

      Abstract

      Background and Objectives

      To evaluate and map the reporting and methodological quality of network meta-analysis (NMA) on acupuncture.

      Methods

      Published acupuncture NMAs were searched through eight databases from inception to February 2022. The reporting and methodological quality of included studies was assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Network Meta-Analysis (PRISMA-NMA) statement and the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) checklist.

      Results

      A total of 113 NMAs were identified. Most (99, 87.61%) studies were performed in China. Most studies focused on multiple acupuncture techniques (82.30%), and the main studied ailments were pain and poststroke sequelae (20.24%). The median (interquartile range (IQR)) score of the reporting quality was 26.5 (25–28.5). However, poor reporting rates in the protocol and registration (33.63%) and geometry of the network (35.40%), especially for China-based studies, were identified. The methodological quality of only 2 (1.77%) English studies was high. The reporting rate of Chinese studies was below 15% on each of items 4, 7, 10, and 12.

      Conclusion

      The reporting quality of the NMAs was moderate, but the methodological quality was very low. The reporting and methodological quality of future NMAs, especially for Chinese studies, need further improvement.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Clinical Epidemiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Committee CAoIM -A.
        Expert guidance on acupoint stimulation to prevent postoperative nausea and vomiting.
        J Clin Anesth. 2019; 35
        • Qu F.
        • Li R.
        • Sun W.
        • Lin G.
        • Zhang R.
        • Yang J.
        • et al.
        Use of electroacupuncture and transcutaneous electrical acupoint stimulation in reproductive medicine:a group consensus.
        J Zhejiang Univ Sci B. 2017; 18: 186-193
        • Wu L.
        • Xu X.J.
        • Lin L.
        Clinical application guideline of traditional Chinese medicine pulmonary rehabilitation therapy for chronic obstructive pulmonary disease.
        J Chin Med. 2021; 62: 2018-2024
        • Cao X.
        Acupuncture research has great promise: from the NIH hearing on acupuncture therapy.
        Chin J Integrated Traditional West Med. 1998; 10: 87-89
        • World Health Organization
        WHO traditional medicine strategy: 2014-2023.
        WHO, Geneva Switzerland2013
        • Kong J.T.
        • Puetz C.
        • Tian L.
        • Haynes I.
        • Lee E.
        • Stafford R.S.
        • et al.
        Effect of electroacupuncture vs sham treatment on change in pain severity among adults with chronic low back pain: a randomized clinical trial.
        JAMA Netw Open. 2020; 3: e2022787
        • Liu Z.
        • Yan L.
        • Xu H.
        • He L.
        • Chen Y.
        • Fu L.
        • et al.
        Effect of electroacupuncture on urinary leakage among women with stress urinary incontinence: a randomized clinical trial.
        JAMA. 2017; 317: 2493
        • Xu S.
        • Yu L.
        • Luo X.
        • Wang M.
        • Chen G.
        • Zhang Q.
        • et al.
        Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura: multicentre, randomised clinical trial.
        BMJ. 2020; 368: m697
        • Gao L.
        • Chen B.
        • Guo Y.
        Comparative analysis of western acupuncture and Chinese acupuncture.
        Liaoning J TCM. 2015; 42: 3
        • Huo R.
        • Ma S.
        Trying to solve the confusion of modern clinical research on acupuncture therapy.
        Chin J Integrated Traditional West Med. 2016; 36: 5
        • Li X.
        • Wang R.
        • Xing X.
        • Shi X.
        • Tian J.
        • Zhang J.
        • et al.
        Acupuncture for myofascial pain syndrome: a network meta-analysis of 33 randomized controlled trials.
        Pain Physician. 2017; 20: E883
        • Li X.
        • Wang R.
        • Shi X.
        • Chen Z.
        • Pan Y.
        • Li X.
        • et al.
        Reporting characteristics and risk of bias in randomised controlled trials of acupuncture analgesia published in PubMed-listed journals.
        Acupunct Med. 2017; 35: 259-267
        • Claxton K.
        • Palmer S.
        • Longworth L.
        • Bojke L.
        • Griffin S.
        • McKenna C.
        • et al.
        Informing a decision framework for when NICE should recommend the use of health technologies only in the context of an appropriately designed programme of evidence development.
        Health Technol Assess. 2012; 16: 1-323
        • Jansen J.P.
        • Naci H.
        Is network meta-analysis as valid as standard pairwise meta-analysis? It all depends on the distribution of effect modifiers.
        Bmc Med. 2013; 11: 159
        • Hartling L.
        • Vandermeer B.
        • Fernandes R.M.
        Systematic reviews, overviews of reviews and comparative effectiveness reviews: a discussion of approaches to knowledge synthesis.
        Evid Based Child Health. 2014; 9: 486-494
        • Stewart G.B.
        • Mengersen K.
        • Meader N.
        Potential uses of Bayesian networks as tools for synthesis of systematic reviews of complex interventions.
        Res Synth Methods. 2014; 5: 1-12
        • Catalá-López F.
        • Tobías A.
        • Cameron C.
        • Moher D.
        • Hutton B.
        Network meta-analysis for comparing treatment effects of multiple interventions: an introduction.
        Rheumatol Int. 2014; 34: 1489-1496
        • Bhatnagar N.
        • Lakshmi P.
        • Jeyashree K.
        Multiple treatment and indirect treatment comparisons: an overview of network meta-analysis.
        Perspect Clin Res. 2014; 5: 154-158
        • Lumley T.
        Network meta-analysis for indirect treatment comparisons.
        Statist Med. 2002; 21: 2313-2324
        • Grant R.L.
        The uptake of Bayesian methods in biomedical meta-analyses: a scoping review (2005-2016).
        J Evid Based Med. 2019; 12: 69-75
        • Liang Y.
        • Rao S.
        • Chen Y.L.
        • Wang Q.
        • Wei D.
        • Wang X.
        • et al.
        The quality of evidence in Chinese meta-analyses needs to be improved.
        J Clin Epidemiol. 2016; 74: 73-79
        • Yan P.
        • Yao L.
        • Li H.
        • Zhang M.
        • Xun Y.
        • Li M.
        • et al.
        The methodological quality of robotic surgical meta-analyses needed to be improved: a cross-sectional study.
        J Clin Epidemiol. 2018; 109: 20-29
        • Brian H.
        • Georgia S.
        • Anna C.
        • Caldwell D.M.
        • Schmid C.
        • Thorlund K.
        • et al.
        The quality of reporting methods and results in network meta-analyses: an overview of reviews and suggestions for improvement.
        PLoS One. 2014; 9: e92508
        • Li L.
        • Tian J.
        • Tian H.
        • Moher D.
        • Liang F.
        • Jiang T.
        • et al.
        Network meta-analyses could be improved by searching more sources and by involving a librarian.
        J Clin Epidemiol. 2014; 67: 1001-1007
        • B Af Eta A.
        • Trinquart L.
        • Seror R.
        • Ravaud P.
        Analysis of the systematic reviews process in reports of network meta-analyses: methodological systematic review.
        BMJ. 2013; 347: f3675
        • Nubaumer B.
        • Gartlehner G.
        • Kien C.
        • Kaminski-Hartenthaler A.
        • Langer G.
        • Meerpohl J.J.
        • et al.
        GRADE guidelines: 15. Going from evidence to recommendation—determinants of a recommendation's direction and strength.
        Z Evidenz Fortbildung Qualitat Im Gesundheitswesen. 2013; 66: 726-735
        • Carroll K.
        • Hemmings R.
        On the need for increased rigour and care in the conduct and interpretation of network meta-analyses in drug development.
        Pharm Stat. 2016; 15: 135-142
        • Jing Z.
        • Carlin B.P.
        • Neaton J.D.
        • Soon G.G.
        • Nie L.
        • Kane R.
        • et al.
        Network meta-analysis of randomized clinical trials: reporting the proper summaries.
        Clin Trials. 2014; 11: 246-262
        • Lee A.W.
        Review of mixed treatment comparisons in published systematic reviews shows marked increase since 2009.
        J Clin Epidemiol. 2014; 67: 138-143
        • Shea B.J.
        • Reeves B.C.
        • Wells G.
        • Thuku M.
        • Hamel C.
        • Moran J.
        • et al.
        AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both.
        BMJ. 2017; 358: j4008
        • Liberati A.
        • Altman D.G.
        • Tetzlaff J.
        • Mulrow C.
        • Gøtzsche P.C.
        • Ioannidis J.P.A.
        • et al.
        The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration.
        BMJ. 2009; 339: b2700
        • Hutton B.
        • Salanti G.
        • Caldwell D.M.
        • Chaimani A.
        • Schmid C.H.
        • Cameron C.
        • et al.
        The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations.
        Ann Intern Med. 2015; 162: 777-784
        • Yuan T.
        • Xiong J.
        • Wang X.
        • Yang J.
        • Jiang Y.
        • Zhou X.
        • et al.
        The quality of methodological and reporting in network meta-analysis of acupuncture and moxibustion: a cross-sectional survey.
        Evid Based Complement Alternat Med. 2021; 2021: 1-15
        • Bae K.
        • Shin I.-S.
        Critical evaluation of reporting quality of network meta-analyses assessing the effectiveness of acupuncture.
        Complement Ther Clin Pract. 2021; 45: 101459
        • Ernst E.
        Acupuncture.
        Lancet Oncol. 2010; 11: 20
        • Schlaeger J.M.
        • Gabzdyl E.M.
        • Bussell J.L.
        • Takakura N.
        • Yajima H.
        • Takayama M.
        • et al.
        Acupuncture and acupressure in labor.
        J Midwifery Womens Health. 2017; 62: 12-28
        • Peter W.
        Laser acupuncture: past, present, and future.
        Lasers Med Sci. 2004; 19: 69-80
        • Ge L.
        • Tian J.H.
        • Li Y.N.
        • Pan J.X.
        • Li G.
        • Wei D.
        • et al.
        Association between prospective registration and overall reporting and methodological quality of systematic reviews: a meta-epidemiological study.
        J Clin Epidemiol. 2018; 93: 45-55
        • Ge L.
        • Tian J.H.
        • Li X.X.
        • Song F.
        • Li L.
        • Zhang J.
        • et al.
        Epidemiology characteristics, methodological assessment and reporting of statistical analysis of network meta-analyses in the field of cancer.
        Sci Rep. 2016; 6: 37208
        • Tian J.
        • Zhang J.
        • Ge L.
        • Yang K.
        • Song F.
        The methodological and reporting quality of systematic reviews from China and the USA are similar.
        J Clin Epidemiol. 2017; 85: 50-58
        • Li J.
        • Gao W.
        • Punja S.
        • Ma B.
        • Vohra S.
        • Duan N.
        • et al.
        Reporting quality of N-of-1 trials published between 1985 and 2013: a systematic review.
        J Clin Epidemiol. 2016; 76: 57-64
        • Bragge P.
        • Clavisi O.
        • Turner T.
        • Tavender E.
        • Collie A.
        • Gruen R.L.
        The global evidence mapping initiative: scoping research in broad topic areas.
        BMC Med Res Methodol. 2011; 11: 92
        • Li Y.
        • Cao L.
        • Zhang Z.
        • Hou L.
        • Qin Y.
        • Hui X.
        • et al.
        Reporting and methodological quality of COVID-19 systematic reviews needs to be improved: an evidence mapping.
        J Clin Epidemiol. 2021; 135: 17-28
        • Tian J.
        • Li L.
        • Zhao Y.
        Writing and reporting of network meta-analysis.
        Chin J Drug Eval. 2013; 30: 333
        • Page M.J.
        • Shamseer L.
        • Altman D.G.
        • Tetzlaff J.
        • Sampson M.
        • Tricco A.C.
        • et al.
        Epidemiology and reporting characteristics of systematic reviews of biomedical research: a cross-sectional study.
        PLoS Med. 2016; 13: e1002028
        • Zhang L.B.
        • Zhou J.
        • Wang P.P.
        • Xiong Z.C.
        • Li W.H.
        • Wang Y.L.
        • et al.
        Network meta-analysis of five acupuncture treatments for lumbar disc herniation.
        J Hainan Med Univ. 2020; 26: 42-48
        • Lan K.
        • Yu H.B.
        • Hu L.Y.
        • Wu X.X.
        A reticular meta-analysis of cervical spondylotic radiculopathy with different acupuncture treatments.
        J Yunnan Univ Traditional Chin Med. 2020; 43: 59-68
        • Liu J.
        • Nie G.N.
        • Li Y.
        • Wen Z.
        • Lu L.
        • Xie L.
        • et al.
        Nonhormonal hot flash management for breast cancer survivors: a systematic review and network meta-analysis.
        Evid Based Complement Alternat Med. 2020; 2020: 4243175
        • Glasziou P.P.
        • Sanders S.
        • Hoffmann T.
        Waste in covid-19 research.
        BMJ. 2020; 369: m1847
        • Luo S.
        • Long Y.
        • Xiao W.
        • Wang X.
        • Chen R.
        • Guo Q.
        • et al.
        Risk of bias assessments and reporting quality of systematic reviews and randomized controlled trials examining acupuncture for depression: an overview and meta-epidemiology study.
        J Evid Based Med. 2020; 13: 25-33
        • Li X.
        • Li Y.
        • Guo K.
        • Chen N.
        • Cui X.
        • Bai Z.
        • et al.
        Evidence based social science in China paper 2: the quality of social science RCTs published from 2000–2020.
        J Clin Epidemiol. 2022; 141: 64-73
        • He G.
        Research on traditional acupuncture therapies and modern acupuncture application techniques.
        J Chin Aesthet Med. 2011; 20: 462-463
        • Ya-Jun W.
        • Ya-Li L.
        • Ke-Hu Y.
        • Guo Y.
        Based on evidence to establish reporting guidelines for TCM-featured acupuncture systematic reviews/Meta-analysis:a methodology discussion.
        Zhongguo Zhen Jiu. 2014; 34: 1231-1234