Evidence map›Paper›PMID 19174438›Full record

SynthesisBMJ (Clinical research ed.)2009

Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups.

Matias Vested Madsen, Peter C Gøtzsche, Asbjørn Hróbjartsson

Registry-linked trialOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04464954 (Pilot Study), which is not on this map. Cited by 129 papers, 19 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
129citing papers in PubMed, 19 pooled it
111.9field-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.

NCT04464954 nacompletednot on this mapstarted 2020, after this paper: background citation

Pilot Study: Effect of Battlefield Acupuncture Needle Selection on Symptom Relief and Patient Tolerance in the Treatment of Pain

TypeinterventionalSponsorPaul CrawfordRan2020 to 2021Enrolled30ConditionsMusculoskeletal Pain, Acute PainArmsAuricular semi-permanent (ASP gold) needles, Intradermal (long) needles using J-type No. 2 (.18)x 15mm, Pyonex needles (Seirin Yellow 0.2 x 0.6mm)
3 · Its place in the literature

Who cites it

129 citing papers in PubMed, 19 syntheses or guidelines pooled it, 365 citations in OpenAlex.

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  15. Auriculotherapy for pain management: a systematic review and meta-analysis of randomized controlled trials.Journal of alternative and complementary medicine (New York, N.Y.) · 2010
    Pooled it
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  17. Guideline
  18. Placebo interventions for all clinical conditions.The Cochrane database of systematic reviews · 2010
    Pooled it
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  20. Trial

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Matias Vested MadsenNordic Cochrane Centre, Rigshospitalet, Department 3343, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
Peter C Gøtzsche
Asbjørn Hróbjartsson
Rigshospitalet · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo study the analgesic effect of acupuncture and placebo acupuncture and to explore whether the type of the placebo acupuncture is associated with the estimated effect of acupuncture.

designSystematic review and meta-analysis of three armed randomised clinical trials. DATA SOURCES: Cochrane Library, Medline, Embase, Biological Abstracts, and PsycLIT. Data extraction and analysis Standardised mean differences from each trial were used to estimate the effect of acupuncture and placebo acupuncture. The different types of placebo acupuncture were ranked from 1 to 5 according to assessment of the possibility of a physiological effect, and this ranking was meta-regressed with the effect of acupuncture. DATA SYNTHESIS: Thirteen trials (3025 patients) involving a variety of pain conditions were eligible. The allocation of patients was adequately concealed in eight trials. The clinicians managing the acupuncture and placebo acupuncture treatments were not blinded in any of the trials. One clearly outlying trial (70 patients) was excluded. A small difference was found between acupuncture and placebo acupuncture: standardised mean difference -0.17 (95% confidence interval -0.26 to -0.08), corresponding to 4 mm (2 mm to 6 mm) on a 100 mm visual analogue scale. No statistically significant heterogeneity was present (P=0.10, I(2)=36%). A moderate difference was found between placebo acupuncture and no acupuncture: standardised mean difference -0.42 (-0.60 to -0.23). However, considerable heterogeneity (P<0.001, I(2)=66%) was also found, as large trials reported both small and large effects of placebo. No association was detected between the type of placebo acupuncture and the effect of acupuncture (P=0.60).

conclusionsA small analgesic effect of acupuncture was found, which seems to lack clinical relevance and cannot be clearly distinguished from bias. Whether needling at acupuncture points, or at any site, reduces pain independently of the psychological impact of the treatment ritual is unclear.

Indexed as

Acupuncture AnalgesiaAcupuncture TherapyHumansPainPlacebosRandomized Controlled Trials as TopicTreatment OutcomePlacebos

Identifiers

PMID19174438
PMCPMC2769056
OpenAlexW2106666670

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.