Evidence map›Paper›PMID 40010834›Full record

SynthesisBMJ open2025

Efficacy and safety of balneotherapy in rheumatology: a systematic review and meta-analysis.

Ikram Aribi, Mikail Nourredine, Caroline Giroudon, Emmanuel Massy, Jean-Christophe Lega, Behrouz Kassai, Guillaume Grenet

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 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.

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

2 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
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

7 authors.

Ikram AribiLaboratoire de biométrie et biologie évolutive, Université Lyon 1, UMR CNRS 5558, Lyon, France.
Mikail NourredineLaboratoire de biométrie et biologie évolutive, Université Lyon 1, UMR CNRS 5558, Lyon, France.
Caroline GiroudonTeam aux chercheurs, service de la documentation centrale, Hospices Civils de Lyon, Lyon, France.ORCID http://orcid.org/0000-0001-7947-9437
Emmanuel MassyService de rhumatologie, centre hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France.ORCID http://orcid.org/0000-0002-4842-8618
Jean-Christophe LegaLaboratoire de biométrie et biologie évolutive, Université Lyon 1, UMR CNRS 5558, Lyon, France.ORCID http://orcid.org/0000-0002-9398-2968
Behrouz KassaiLaboratoire de biométrie et biologie évolutive, Université Lyon 1, UMR CNRS 5558, Lyon, France.
Guillaume GrenetLaboratoire de biométrie et biologie évolutive, Université Lyon 1, UMR CNRS 5558, Lyon, France guillaume.grenet@ubc.ca.ORCID http://orcid.org/0000-0002-5237-2581

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe efficacy of balneotherapy in rheumatology remains unclear. We aimed to estimate its benefits and risks in rheumatology.

methodsWe conducted a systematic review of randomised trials assessing any European balneotherapy for a rheumatological indication in adults versus any control, on clinical outcomes. We searched PubMed, Cochrane Library, Embase and https://clinicaltrials.gov/ (up to 28 November 2023). We used the Cochrane risk of bias tool version 2, funnel plot and asymmetry tests. We used a random effects model with an inverse-variance weighting method for standardised mean difference (SMD) and risk ratio (RR). We used the Grading of Recommendations Assessment, Development and Evaluation approach for two primary outcomes, pain and quality of life (QoL) at 3 months, and two safety outcomes, withdrawal and any adverse event (AE).

resultsWe included 29 trials in mechanical disorders, 9 in inflammatory diseases and 4 in fibromyalgia. The synthesis suggested a decrease in pain of a very low level of certainty (SMD: -0.72 (95% CI (-1.00; -0.44)), very serious risk of bias and of inconsistency, publication bias strongly suspected); an increase in QoL of a very low level of certainty (SMD: 0.56 (95% CI (0.37; 0.75)), very serious risk of bias and serious risk of inconsistency); inconclusive results regarding the risk of withdrawal (RR: 0.75 (95% CI (0.46; 1.20)), very serious risk of bias and serious risk of imprecision) and of AE (RR: 0.80 (95% CI (0.43; 1.50)), serious risk of bias and of inconsistency and very serious risk of imprecision).

conclusionThe certainty of the effect of balneotherapy in rheumatology was very low. PROSPERO REGISTRATION NUMBER: CRD42023448206.

Indexed as

BalneologyRheumatic DiseasesRheumatologyHumansQuality of LifeRandomized Controlled Trials as TopicTreatment OutcomeMeta-AnalysisRHEUMATOLOGYTHERAPEUTICS

Identifiers

PMID40010834
PMCPMC11865765

What OpenQuestion holds

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LicenceCC BY-NC
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.