Clinical Randomized Controlled Study of Acupuncture Treatment on Children with Autism Spectrum Disorder (ASD): A Systematic Review and Meta-Analysis

Table 1

Evidence quality classification.

Certainty assessment

No. of patients

Effect

Certainty

Importance

No. of studies

Study design

Risk of bias

Inconsistency

Indirectness

Imprecision

Other considerations

Acupuncture

Rehabilitation training

Relative (95% CI)

Absolute (95% CI)

CARS

9

Randomised trials

Serious^a

Serious^b

Not serious

Not serious

None

356

367

—

MD 4.6 lower (5.09 lower to 4.1 lower)

⊕⊕○○; Low

Critical

CARS, acupuncture subgroup

7

Randomised trials

Serious^a

Not serious

Not serious

Not serious

None^c

258

269

—

MD 2.65 lower (3.22 lower to 2.07 lower)

⊕⊕⊕○; Moderate

Critical

CARS, acupuncture plus massage subgroup

2

Randomised trials

Serious^a

Not serious

Not serious

Serious^d

Publication bias strongly suspected^c

98

98

—

MD 10.35 lower (11.34 lower to 9.36 lower)

⊕○○○; Very low

Critical

ABC

10

Randomised trials

Serious^a

Serious^b

Not serious

Not serious

Publication bias strongly suspected^e

411

408

—

MD 7.38 more (8.03 more to 6.74 more)

⊕○○○; Very low

Critical

ABC (sensory)

2

Randomised trials

Serious^a

Not serious

Not serious

Serious^d

Publication bias strongly suspected^c

76

75

—

MD 2.67 more (2.9 more to 2.44 more)

⊕○○○; Very low

Important

ABC (social/self-help)

2

Randomised trials

Serious^a

Not serious

Not serious

Serious^d

Publication bias strongly suspected^c

76

75

—

MD 2.09 more (2.3 more to 1.89 more)

⊕○○○; Very low

Important

ABC (body and object use)

2

Randomised trials

Serious^a

Not serious

Not serious

Serious^d

Publication bias strongly suspected^c

76

75

—

MD 1.19 more (1.38 more to 1 more)

⊕○○○; Very low

Important

ABC (relating)

2

Randomised trials

Serious^a

Not ious

Not serious

Serious^d

Publication bias strongly suspected^c

76

75

—

MD 3.28 more (3.55 more to 3.02 more)

⊕○○○; Very low

Important

ABC (language)

2

Randomised trials

Serious^a

Not serious

Not serious

Serious^d

Publication bias strongly suspected^c

76

75

—

MD 2.45 more (2.73 more to 2.16 more)

⊕○○○; Very low

Important

RDLS (CY)

3

Randomised trials

Serious^a

Not serious

Not serious

Serious^d

Publication bias strongly suspected^c

67

59

—

MD 0.15 higher (0.04 higher to 0.26 higher)

⊕○○○; Very low

Important

RDLS (EY)

3

Randomised trials

Serious^a

Not serious

Not serious

Serious^d

Publication bias strongly suspected^c

67

59

—

MD 0.08 higher (0.06 higher to 0.22 higher)

⊕○○○; Very low

Important

WeeFIM

3

Randomised trials

Serious^a

Not serious

Not serious

Serious^d

Publication bias strongly suspected^c

67

59

—

MD 3.7 higher (2.38 higher to 5.02 higher)

⊕○○○; Very low

Important

CI: confidence interval; MD: mean difference. Note.^aThe included studies are biased in allocation concealment and blinding. ^bThe degree of overlap of the credible intervals of different studies is poor, and the I2 value of the combined results is larger. ^c The number of included studies is small, and they are positive, and there is a possibility of greater publication bias. ^dThe sample size does not meet the OIS standard. The form is completed on the GRADE PRO website: http://www.guidelinedevelopment.org/. The symbol “⊕” in the figure represents the level, and the more ⊕, the higher the level. ^eAsymmetric funnel chart.