|
Authors (date)/
country | Condition | Number of RCTs (patients) included | Quality of original studies scale/level | Acu style of SR | Acu adequacy assessment of original studies | Quality of SR | Data analysis methods | Comparisons | Reported results | Authors conclusions/comments [notes] |
| Pain relief | Functional improvement |
|
Lee et al.
(2013) [16]/Korea | Acute NSLBP | 11 (1139) | 2009 CBRGC and additional criteria
(5/11)
Low | TCM, Western | Judged by two experts about two questions | 6 | Meta-
analysis | (1) Sham acu
(2) Medications | +
# | =
NR | Acupuncture may be more effective than medication for symptom improvement or relieve pain better than sham acupuncture in acute NSLBP/include Asian database. Strict criteria of being high quality studies. Emphasize the impact of language restriction and Chinese studies [overall improvement (+) compared to medications] |
|
| Lam et al. (2013) [17]/Ireland | Chronic NSLBP | 32 (5931) | Cochrane risk of bias tool
(7/32)
Low | TCM | NR | 6 | Meta-
analysis | (1) Sham acu
(2) No treatment
(3) Plus usual care
(4) Medications
(5) TENS | +
+
+
+
= | =
+
+
+
NR | Acupuncture may have a favorable effect on pain and function on chronic NSLBP/high heterogeneity of included studies. Confused subgroups. Clear definition of clinical significance. |
|
Wu et al.
(2013) [18]/China | LIDH | 6 (540) | Cochrane risk of bias tool
(NR)
Low | TCM | NR | 5 | Meta-
analysis | Various controls (oral medications, traction, medication injection, or transfusion) | = | NR | Acupuncture is effective and safe for LIDH/article in Chinese. Restricted publication status. No subgroup comparison provided. Quality of evidence evaluated by GRADE [noneffectiveness rate (−)] |
|
Xu et al.
(2013) [19]/China | Chronic LBP | 13 (2678) | 2003
CBRGC
(12/13)
High⊚ | NR | NR | 5 | Meta-
analysis | (1) No treatment
(2) Conventional therapy
(3) Sham acu | +
+
= | +
+
= | Acupuncture is an effective treatment for chronic LBP but may due to nonspecific effects/exclude Asian database other than Chinese. No key studies characteristics provided [no treatment group included blank treatment comparison] |
|
Furlan et al.
(2012) [20]/
Canada | LBP | 33 (NR) | 2009
CBRGC (NR)
NR | NR | NR | 5 | Meta-
analysis | For acute/subacute NSLBP
(1) Sham acu
For chronic NSLBP
(1) Sham therapy
(2) No treatment
(3) Medications
(4) Manipulation
(5) Usual care |
=
+
+
=
−
+ |
=
=
+
=
NR
+ | Same as reported results/not specific to acupuncture. No studies characteristics provided. Quality of evidence evaluated by GRADE. |
|
Li et al.
(2010) [21]/China | LIDH | 5 (718) | Jadad (2/5)
Low | TCM (electro) | NR | 5 | Meta-
analysis | Various controls (oral medications or physiotherapy) | + | NR | Electroacupuncture is effective and safe for LIDH/article in Chinese. Restricted publication status. No subgroup comparison provided. Poor quality of meta-analysis (repeatedly pooled the same study in one analysis) [effective rate (+)] |
|
Rubinstein et al.
(2010) [22]/Netherlands | Chronic NSLBP | 20 (5590) | 2003
CBRGC
(8/20)
Low | TCM | NR | 5 | Meta-
analysis | (1) Sham therapy
(2) No treatment
(3) Plus conventional therapy
(4) Usual acre | +
+
+
+ | +
+
+
+ | Acupuncture provides short-term clinically relevant effects when compared with no treatment or added to other therapies/not specific to acupuncture. No studies characteristics provided. No heterogeneity present. Quality of evidence evaluated by GRADE. |
|
| Machado et al. (2009) [23]/Australia | NSLBP | 4 (149) | PEDro
(4/4)
High⊚ | NR | NR | 3 | Meta-
analysis | Placebo controls | = | NR | Acupuncture is not more effective than placebo/not specific to acupuncture. No studies characteristics provided. No heterogeneity present. |
|
Ammendolia
et al. (2008) [24]/
Canada | Chronic LBP | 19 (5001) | 2003 CBRGC
(10/19)
Low | TCM, Western | NR | 4 | Best-evidence synthesis | (1) Waiting list
(2) Plus conventional therapy
(3) Conventional therapy
(4) Sham therapy | +
+
=
# | +
+
=
= | Same as reported results/lack rigorous format of SR. |
|
| Yuan et al. (2008) [25]/UK | NSLBP | 23 (6359) | 2003 CBRGC and additional criteria (6/23)
Low⊚ | TCM, Western | Compared to textbooks, surveys, and primary reviews | 4 | Meta-
analysis, best-evidence synthesis | (1) No treatment
(2) Plus Conventional therapy
(3) Sham acu
(4) Conventional therapy | +
+
=
# | +
+
=
# | Acupuncture versus no treatment and as an adjunct to conventional care should be advocated in the European Guidelines for chronic LBP/exclude non-English articles. No heterogeneity present. No overall effect size of pooled studies provided. Strict criteria of being high quality studies. Clear definition of clinical significance. |
|
| Li et al. (2008) [26]/China | LIDH | 5 (547) | Jüni
(NR)
High | TCM (electro) | NR | 7 | Meta-
analysis | Various controls (oral medications or physiotherapy) | + | + | Electroacupuncture is effective and safe for LIDH/article in Chinese. No subgroup comparison provided. |
|
Keller et al.
(2007) [27]/Norway | NSLBP | 7 (528) | 2003 CBRGC and Jadad
(NR)
High | NR | NR | 2 | Meta-
analysis | Various controls (sham therapy or no treatment) | + | NR | Acupuncture has modest effect for chronic LBP/not specific to acupuncture. No subgroup comparison provided. |
|
| Manheimer et al. (2005) [28]/USA | LBP | 33 (2300) | 1997 CBRGC and Jadad
(12/33, 17/33)
Low | TCM, Western | NR | 8 | Meta-
analysis | For acute LBP
For chronic LBP
(1) Sham acu
(2) No treatment
(3) Conventional therapy
(4) Manipulation | ⊥
+
+
⊥
− | ⊥
=
+
⊥
− | Acupuncture effectively relieves chronic low back pain. No evidence suggests acupuncture is more effective than other active therapies/exclude Chinese database. Restricted publication status. Clear definition of clinical significance. |
|
| Furlan et al. (2005) [29]/Canada | NSLBP | 35 (2861) | 2003 CBRGC
(14/35)
Low | TCM, Western | Judged by three experienced acupuncturists based on four questions | 9 | Meta-
analysis, best-evidence synthesis | For acute NSLBP
For chronic NSLBP
(1) Sham therapy
(2) No treatment
(3) Plus conventional therapy
(4) Conventional therapy | ⊥
+
+
+
= | ⊥
=
+
+
= | No firm conclusions for acute LBP. For chronic LBP, acupuncture is more effective than no treatment or sham treatment. Acupuncture is not more effective than other conventional treatments. Acupuncture and dry needling may be useful adjuncts to other therapies/include Asian database. High heterogeneity of included studies. Subjective assessment of clinical relevance. |
|
| Zhu et al. (2002) [30]/China | LBP | 9 (426) | NR | TCM | NR | 2 | Meta-
analysis | Various controls (sham acu, TENS, medications, or physiotherapy) | + | NR | Acupuncture might be effective for LBP/article in Japanese. Include Japanese database. No subgroup comparison provided. |
|
| Ernst and White (1998) [31]/UK | Back Pain | 12 (472) | Jadad (10/12)
High | TCM, Western | Judged by six experienced acupuncturists | 8 | Meta-
analysis | Various controls (sham acu, no treatment, TENS et al.) | NR | NR | Acupuncture is superior to various control interventions, but insufficient evidence to judge whether it is superior to placebo/no subgroup comparison provided [symptoms improve (+)] |
|
