Evidence map›Paper›PMID 24146995›Full record

SynthesisPloS one2013

Characteristics of acupuncture treatment associated with outcome: an individual patient meta-analysis of 17,922 patients with chronic pain in randomised controlled trials.

Hugh MacPherson, Alexandra C Maschino, George Lewith, Nadine E Foster, Claudia M Witt, Claudia Witt, Andrew J Vickers, Acupuncture Trialists' Collaboration

Erratum issued Registry-linked trialAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03821194 (The Effect of Chronic Pain Relief Over Knee Joint Area by Gua Sha Therapy), which is not on this map. Cited by 66 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
66citing papers in PubMed, 11 pooled it
–field-weighted citation impact
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.

NCT03821194 naunknown statusnot on this mapstarted 2019, after this paper: background citation

The Effect of Chronic Pain Relief Over Knee Joint Area by Gua Sha Therapy

TypeinterventionalSponsorTaipei Veterans General Hospital, TaiwanRan2019 to 2019Enrolled40ConditionsPain, ChronicArmsGua sha, hot pack
3 · Its place in the literature

Who cites it

66 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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  10. Acupuncture for the prevention of episodic migraine.The Cochrane database of systematic reviews · 2016
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6 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

  • Erratum issued
    Witt, Claudia [corrected to Witt, Claudia M]
5 · Who and what money

Authors and funding

8 authors.

Hugh MacPhersonDepartment of Health Sciences, University of York, York, United Kingdom.
Alexandra C Maschino
George Lewith
Nadine E Foster
Claudia M Witt
Claudia Witt
Andrew J Vickers
Acupuncture Trialists' Collaboration

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
Acupuncture Trialists' Collaboration: meta-analysis of chronic pain trialsR01AT006794 · NCCIH · SLOAN-KETTERING INST CAN RESEARCH · PI VICKERS, ANDREW J · 2011 to 2015
$1.6M
Acupuncture Trialists' Collaboration: meta-analysis of chronic pain trialsR21AT004189 · NCCIH · SLOAN-KETTERING INST CAN RESEARCH · PI VICKERS, ANDREW J · 2008 to 2010
$604k
Department of Health RP-PG-0707-10186NCCIH NIH HHS AT004189INCCIH NIH HHS R01 AT006794NCCIH NIH HHS R21 AT004189NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundRecent evidence shows that acupuncture is effective for chronic pain. However we do not know whether there are characteristics of acupuncture or acupuncturists that are associated with better or worse outcomes.

methodsAn existing dataset, developed by the Acupuncture Trialists' Collaboration, included 29 trials of acupuncture for chronic pain with individual data involving 17,922 patients. The available data on characteristics of acupuncture included style of acupuncture, point prescription, location of needles, use of electrical stimulation and moxibustion, number, frequency and duration of sessions, number of needles used and acupuncturist experience. We used random-effects meta-regression to test the effect of each characteristic on the main effect estimate of pain. Where sufficient patient-level data were available, we conducted patient-level analyses.

resultsWhen comparing acupuncture to sham controls, there was little evidence that the effects of acupuncture on pain were modified by any of the acupuncture characteristics evaluated, including style of acupuncture, the number or placement of needles, the number, frequency or duration of sessions, patient-practitioner interactions and the experience of the acupuncturist. When comparing acupuncture to non-acupuncture controls, there was little evidence that these characteristics modified the effect of acupuncture, except better pain outcomes were observed when more needles were used (p=0.010) and, from patient level analysis involving a sub-set of five trials, when a higher number of acupuncture treatment sessions were provided (p<0.001).

conclusionThere was little evidence that different characteristics of acupuncture or acupuncturists modified the effect of treatment on pain outcomes. Increased number of needles and more sessions appear to be associated with better outcomes when comparing acupuncture to non-acupuncture controls, suggesting that dose is important. Potential confounders include differences in control group and sample size between trials. Trials to evaluate potentially small differences in outcome associated with different acupuncture characteristics are likely to require large sample sizes.

Indexed as

Acupuncture TherapyChronic PainHumansRandomized Controlled Trials as TopicTreatment Outcome

Identifiers

PMID24146995
PMCPMC3795671

What OpenQuestion holds

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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.