Evidence map›Paper›PMID 15023828›Full record

Trial reportBMJ (Clinical research ed.)2004

Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial.

Andrew J Vickers, Rebecca W Rees, Catherine E Zollman, Rob McCarney, Claire M Smith, Nadia Ellis, Peter Fisher, Robbert Van Haselen

Open access · bronzeAbstract readClinical TrialMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
81citing papers in PubMed, 17 pooled it
75.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

81 citing papers in PubMed, 17 syntheses or guidelines pooled it, 319 citations in OpenAlex.

  1. Pooled it
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  8. Acupuncture for the prevention of episodic migraine.The Cochrane database of systematic reviews · 2016
    Pooled it
  9. Acupuncture for the prevention of tension-type headache.The Cochrane database of systematic reviews · 2016
    Pooled it
  10. Pooled it
  11. Pooled it
  12. Acupuncture for insomnia.The Cochrane database of systematic reviews · 2012
    Pooled it
  13. Guideline
  14. The Acupuncture Trialists' Collaboration: individual patient data meta-analysis of chronic pain trials.Acupuncture in medicine : journal of the British Medical Acupuncture Society · 2009
    Pooled it
  15. Acupuncture for tension-type headache.The Cochrane database of systematic reviews · 2009
    Pooled it
  16. Acupuncture for migraine prophylaxis.The Cochrane database of systematic reviews · 2009
    Pooled it
  17. Guideline
  18. Trial
  19. Trial
  20. Trial

21 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 3 countries.

Andrew J VickersIntegrative Medicine Service, Biostatistics Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, NY, NY 10021, USA. vickersa@mskcc.org
Rebecca W Rees
Catherine E Zollman
Rob McCarney
Claire M Smith
Nadia Ellis
Peter Fisher
Robbert Van Haselen
Bristol Homeopathic Hospital · GBCoventry University · GBImperial College London · GBKing's College London · GBMemorial Sloan Kettering Cancer Center · USUniversity College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the effects of a policy of "use acupuncture" on headache, health status, days off sick, and use of resources in patients with chronic headache compared with a policy of "avoid acupuncture."

designRandomised, controlled trial.

settingGeneral practices in England and Wales.

participants401 patients with chronic headache, predominantly migraine. Interventions Patients were randomly allocated to receive up to 12 acupuncture treatments over three months or to a control intervention offering usual care.

main outcome measuresHeadache score, SF-36 health status, and use of medication were assessed at baseline, three, and 12 months. Use of resources was assessed every three months.

resultsHeadache score at 12 months, the primary end point, was lower in the acupuncture group (16.2, SD 13.7, n = 161, 34% reduction from baseline) than in controls (22.3, SD 17.0, n = 140, 16% reduction from baseline). The adjusted difference between means is 4.6 (95% confidence interval 2.2 to 7.0; P = 0.0002). This result is robust to sensitivity analysis incorporating imputation for missing data. Patients in the acupuncture group experienced the equivalent of 22 fewer days of headache per year (8 to 38). SF-36 data favoured acupuncture, although differences reached significance only for physical role functioning, energy, and change in health. Compared with controls, patients randomised to acupuncture used 15% less medication (P = 0.02), made 25% fewer visits to general practitioners (P = 0.10), and took 15% fewer days off sick (P = 0.2).

conclusionsAcupuncture leads to persisting, clinically relevant benefits for primary care patients with chronic headache, particularly migraine. Expansion of NHS acupuncture services should be considered.

Indexed as

Acupuncture TherapyAdolescentAdultAgedChronic DiseaseEnglandFamily PracticeHeadache DisordersHumansMiddle AgedMigraine DisordersTreatment OutcomeWales

Identifiers

PMID15023828
PMCPMC381326
OpenAlexW2138955176

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.