Comparing Verum and Sham Acupuncture in Fibromyalgia Syndrome: A Systematic Review and Meta-Analysis
Table 2
The quality of evidence.
Outcome
Certainty assessments
Summary of finding
Study design
Risk of bias
Inconsistency
Indirectness
Imprecision
Other considerations
Effect (95% CI)
Certainty
Intensity of pain
Verum acupuncture versus sham acupuncture
RCT
Not seriousa
Seriousb
Not seriousc
Not seriousd
Nonee
SMD −0.49 (−0.79∼−0.2)
⊕⊕⊕◯ MODERATE
Verum acupuncture versus simulated acupuncture on appropriate points
RCT
Not seriousa
Very seriousf
Not seriousc
Seriousg
Nonee
SMD −0.54 (−1.19 ∼ 0.1)
⊕◯◯◯ VERY LOW
Verum acupuncture versus acupuncture on inappropriate points
RCT
Not seriousa
Seriousb
Not seriousc
Serioush
Nonee
SMD −0.63 (−1.23∼−0.04)
⊕⊕◯◯ LOW
Verum acupuncture versus simulated acupuncture on inappropriate points
RCT
Not seriousa
Not seriousi
Not seriousc
Not seriousd
Nonee
SMD −0.37 (−0.67∼−0.08)
⊕⊕⊕⊕ HIGH
Fatigue
Verum acupuncture versus sham acupuncture
RCT
Seriousj
Not seriousj
Not seriousc
Seriousk
Nonee
SMD −0.1 (−0.51 ∼ 0.3)
⊕⊕◯◯ LOW
Sleep quality
Verum acupuncture versus sham acupuncture
RCT
Not seriousa
Not seriousj
Not seriousc
Not seriousd
Nonee
SMD −0.46 (−0.75∼−0.18)
⊕⊕⊕⊕ HIGH
General status
Verum acupuncture versus sham acupuncture
RCT
Not seriousa
Not seriousj
Not seriousc
Not seriousd
Nonee
SMD −0.69 (−0.91∼−0.47)
⊕⊕⊕⊕ HIGH
Verum acupuncture versus simulated acupuncture on appropriate points
RCT
Not seriousa
Not seriousj
Not seriousc
Not seriousd
Nonee
SMD −0.71 (−1.04∼−0.39)
⊕⊕⊕⊕ HIGH
Verum acupuncture versus acupuncture on inappropriate points
RCT
Not seriousa
Not seriousj
Not seriousc
Seriousl
Nonee
SMD −0.79 (−1.22∼−0.35)
⊕⊕⊕◯ MODERATE
RCT, randomized controlled trial; CI, confidence interval; SMD, standardized mean difference. aThe proportion of studies assessed as high risk of bias was less than 25%; bI2 was 50% or more and less than 75%; cdirectness was undoubted; dtotal sample size was more than 200, and 95% CI of SMD did not cross zero; epublication bias was not identified; fI2 was 75% or more; gtotal sample size was in the range of 101 to 200, and 95% CI of SMD crossed zero; htotal sample size was in the range of 101 to 200; iI2 was less than 50%; jthe proportion of studies assessed as high risk of bias is in the range of 25% to 50%; ktotal sample size was more than 200, and 95% CI of SMD crossed zero; ltotal sample size was less than 100.
