Efficacy and Safety of Acupuncture in the Treatment of Poststroke Insomnia: A Systematic Review and Meta-Analysis of Twenty-Six Randomized Controlled Trials

Table 3

GRADE summary table of the outcome indicators evidence quality.

Acupuncture compared to drug for poststroke insomnia
Patient or population: patients with poststroke insomnia
Intervention: acupuncture
Comparison: drug
Outcomes	Illustrative comparative risks (95% CI)		Relative effect (95% CI)	No. of participants (studies)	Quality of the evidence (GRADE)
	Assumed risk	Corresponding risk
	Drug	Acupuncture
Clinical effective rate	Study population		RR 1.23 (1.18 to 1.29)	1686 (24 studies)	⊕⊕⊝⊝low^1,2
	749 per 1000	921 per 1000 (884 to 966)
	Medium risk population
	767 per 1000	943 per 1000 (905 to 989)
PQSI score		The mean PQSI score in the intervention groups was 3.41 higher (2.4 to 4.41 higher)		1606 (22 studies)	⊕⊕⊝⊝low^1,2
Adverse reactions	Study population		RR 0.17 (0.09 to 0.32)	353 (5 studies)	⊕⊝⊝⊝very low^1,2,3
	309 per 1000	53 per 1000 (28 to 99)
	Medium risk population
	200 per 1000	34 per 1000 (18 to 64)

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). CI: confidence interval; RR: risk ratio; GRADE: working group grades of evidence. High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate. ¹Some of the studies did not describe randomization, and none of the studies described blinding of participants and personnel, as well as blinding of outcome assessment. ²Funnel plot test showed publication bias in the results. ³Downgrading a notch was conducted because the number of included studies is small, and the confidence interval is wide.