Acupuncture for Pain Management in Cancer: A Systematic Review and Meta-Analysis

Table 2

Grade Quality of evidence of acupuncture plus drug therapy for cancer pain.

Outcomes	Illustrative comparative risks (95% CI)		Relative effect (95% CI)	Number of participants (studies)	Quality of the evidence; (GRADE)
	Assumed risk Control	Corresponding risk Acupuncture plus analgesic
Response rate for relieving pain; pain scale; Follow-up: 7–30 days	772 per 1000; 816 per 1000	Study population; 911 per 1000 (841 to 980); Moderate; 963 per 1000 (889 to 1000)	RR 1.18 (1.09 to 1.27)	845 (11 studies)	⊕  ⊝  ⊝  ⊝; Very low^1,4
Onset time of pain relief; Follow-up: 7–28 days		The mean onset time of pain relief in the intervention groups was; 1.06 standard deviations lower; (1.34 to 0.79 lower)		230 (4 studies)	⊕  ⊝  ⊝  ⊝; Very low^1,2,3
Duration of pain relief; Follow-up: 7–28 days		The mean duration of pain relief in the intervention groups was; 1.03 standard deviations higher; (0.49 to 1.57 higher)		268 (5 studies)	⊕  ⊝  ⊝  ⊝; Very low^1,2,3,4
QOL; Follow-up: 7–30 days		The mean score of QOLl in the intervention groups was; 1.44 standard deviations higher; (0.43 to 2.44 higher)		196 (3 studies)	⊕  ⊝  ⊝  ⊝; Very low^1,2,3,4

None of the trials were blinded; most of them did not mention randomization process and allocation concealment.
Total sample size is less than calculated optimal information size.
Published evidence is limited to a small number of trials, all of which are showing benefits.
Confidence intervals with minimal overlap, the heterogeneity is significant.
The GRADE profile noted “” means the basis for the assumed risk (e.g., the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).